Fluorescein Angiography and Spectral-Domain Optical Coherence Tomography Features in Classic Choroidal Neovascularization due to Age-Related Macular Degeneration

Purpose:To evaluate the combined Fluorescein Angiography (FA) and Spectral-Domain Optical Coherence Tomography (SD-OCT) features in a consecutive series of eyes affected with classic choroidal neovascularization (CNV) due to age-related macular degeneration (AMD) before and after anti-VEGF therapy. Methods:Retrospective interventional study. All consecutive patients with newly diagnosed classic CNV and treated by intravitreal ranibizumab injection on "as needed" basis, were analyzed. Combined FA and SD-OCT examination (Spectralis HRA-OCT Heidelberg Engineering, Heidelberg, Germany) was performed at baseline and at the 12-month follow-up visit. Results:Twenty-nine treatment-naive eyes (29 patients, 10 males, 19 females, mean age 76.28±10.86) were included. A mean of 5.3±3.5 injections was administered during 12 months. At month-12, patients showed an improved BCVA (p=0.01), a reduction of linear dimension of the entire lesion on FA (p=0.02), and a reduction of the lesion width on SD-OCT (p<0.001).At baseline and in all cases, SD-OCT showed a highly reflective subretinal lesion, above and separate from the retinal pigment epithelium (RPE) layer. The highly reflective subretinal lesion showed a significant reduction of width at month-12 (p<0.001). A small "discreet" pigment epithelium detachment (PED) associated with the highly reflective subretinal lesion was present in 28/29 eyes at baseline and after treatment (at month-12). Conclusions:A "discreet" PED represents a common associated finding of classic CNV. This study demonstrate that anti-VEGF treatment may not only stop the growth of the highly reflective subretinal lesion that co-localize with the classic CNV, but even determine the regression of the lesion.