High-resolution fourier-domain optical coherence tomography of choroidal neovascular membranes associated with age-related macular degeneration

PURPOSE. To investigate the use of high-resolution Fourierdomain optical coherence tomography (Fd-OCT) to image choroidal neovascular membranes (CNVMs) associated with exudative age-related macular degeneration (eAMD). METHODS. An Fd-OCT instrument with axial resolution of 4 to 4.5 μm and transverse resolution of 10 to 15 μm was used to image 21 eyes (19 subjects) with newly diagnosed eAMD. A raster series of 100 B-scans separated by 60 μm was used to study the growth pattern of CNVM and associated morphologic changes. CNVM size was determined using 250 to 300 serial virtual C-scans of reconstructed three-dimensional macular volume. RESULTS. A highly reflective subretinal and/or subretinal pigment epithelial (RPE) lesion that co-localized with the CNVM seen on fluorescein angiography was detected in all eyes by Fd-OCT. Although a combined subretinal and sub-RPE growth pattern of various degrees was noted in 15 (71%) eyes, a statistically significant difference in the distribution of growth pattern was noted when classic CNVM was compared with occult CNVM (X²= 10.4, df = 2, P < 0.005). Classic lesions had >90% subretinal growth pattern, whereas occult lesions had a more variable growth pattern. Angiographic CNVM size correlated with size on Fd-OCT but correlation was better for classic CNVM (classic, r = 0.99, P < 0.0001; nonclassic, r = 0.78, P < 0.001). CONCLUSIONS. Fd-OCT is a promising potential alternative modality to visualize CNVM with AMD. Angiographic lesion size and type correlated with growth pattern and size of CNVM on Fd-OCT, with correlation being stronger for classic lesions.