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Comparison of UHR-OCT versus Stratus-OCT for definition of early retinal changes after intravitreal Bevacizumab (Avastin®) application in patients with AMD

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Zusammenfassung

ZIELSETZUNG: Vergleich des Standard Stratus OCT Systems (S-OCT) mit einem Ultra High Resolution OCT (UHR-OCT) zur Untersuchung und Darstellung früher struktureller Veränderungen in der funktionellen Einheit aus Netzhaut, Pigmentepithel und Choriocapillaris, vor und 10 ± 3 Tage nach der intravitrealen Applikation von Bevacizumab (Avastin®) bei Patienten mit neovasculärer altersbedingter Makuladegeneration (nAMD). METHODEN: Sechs Patienten mit nAMD wurden in einer konsekutiven Fallserie mit einem UHR-OCT System und dem Stratus OCT einen Tag vor und 10 ± 3 Tage nach der intravitrealen Applikation von 1,25 mg (0,125 ml) Bevacizumab (Avastin®) untersucht. Die maximale Netzhautdicke (CRT) wurde mit dem retinal thickness measurement und calliper Programm des Stratus OCT, beziehungsweise mit dem measuring tool in Adobe Photoshop 5.0 bei den UHR-OCT Bildern vermessen. ERGEBNISSE: In drei von sechs Fällen war verbleibende intraretinale Flüssigkeit nur mehr in den UHR-OCT Bildern darstellbar. Eine Abnahme der maximalen Netzhautdicke (CRT) konnte in den UHR-OCT Bildern in allen, in den S-OCT Bildern nur in der Hälfte der Fälle (6/3) gezeigt werden. In 2/6 Fällen konnten vitreoretinale Adhäsionen nur mit dem UHR-OCT System dargestellt werden, nicht aber mit dem S-OCT. Unregelmässigkeiten in der Schicht der Photorezeptoren konnten mit dem UHR-OCT System eindeutig in 2/6 Fällen gezeigt werden. SCHLUSSFOLGERUNG: Das UHR-OCT System gibt klarer Auskunft über verbleibende intraretinale Flüssigkeit und Schäden in der Netzhautstruktur nach anti-VEGF Behandlung als das Stratus OCT. Es kann ausserdem eine genauere Messung der maximalen CRT ermöglichen.

Summary

PURPOSE: To investigate and demonstrate early structural changes of the retina/pigmentepithelial/choriocapillaris (RPECC) complex before and 10 ± 3 days after intravitreal application of bevacizumab (Avastin®) in patients with neovascular age related macular degeneration (nAMD) by comparison of standard Stratus Optical Coherence Tomography (S-OCT) and Ultra High Resolution (UHR-OCT) imaging systems. METHODS: Six patients with nAMD were examined in a consecutive case series with UHR-OCT and Stratus OCT one day before and 10 ± 3 days after intravitreal application of 1.25 mg (0.125 ml) bevacizumab (Avastin®). Maximum central retinal thickness (CRT) was measured with the retinal thickness program and calliper measuring function of S-OCT and by the measuring tool of Adobe Photoshop 5.0 in UHR-OCT pictures. RESULTS: In three of six cases residual fluid after treatment was only visible with UHR-OCT but not with the S-OCT. A decrease of maximum CRT could be shown in all cases in UHR-OCT pictures but only in half of the cases (6/3) in S-OCT pictures. In 2/6 cases vitreoretinal adhesions were demonstrable with UHR-OCT but not seen with the S-OCT, irregularities in the photoreceptor layer could be revealed clearly by UHR-OCT in 2/6 cases. CONCLUSION: After anti-VEGF treatment, UHR–OCT gives more accurate information about residual fluid and intraretinal damage than S-OCT and offers more precise measurements of maximum CRT. These factors may influence further decision of therapy and give us a better explanation and correlation with unsatisfactory visual acuities than with the S-OCT.

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Authors and Affiliations

  1. Department of Ophthalmology, Rudolf Foundation Clinic, Vienna, Austria

    F. Zeiler, C. Glittenberg & S. Binder

  2. Ludwig Boltzmann Institute for Retinology and Biomicroscopic Laser Surgery, Department of Ophthalmology, Rudolf Foundation Clinic, Vienna, Austria

    S. Hagen, S. Lie & S. Binder

  3. Biomedical Imaging Group, Department of Optometry & Vision Sciences, Cardiff University, Wales, UK

    B. Považay, B. Hermann & W. Drexler

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  1. F. Zeiler
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  2. B. Považay
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  3. C. Glittenberg
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  4. B. Hermann
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  5. S. Hagen
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  6. S. Lie
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  7. W. Drexler
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  8. S. Binder
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Correspondence to F. Zeiler.

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Zeiler, F., Považay, B., Glittenberg, C. et al. Comparison of UHR-OCT versus Stratus-OCT for definition of early retinal changes after intravitreal Bevacizumab (Avastin®) application in patients with AMD. Spektrum Augenheilkd. 23, 30–35 (2009). https://doi.org/10.1007/s00717-009-0313-1

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  • DOI: https://doi.org/10.1007/s00717-009-0313-1

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