Article
Longitudinal Changes due to Geographic Atrophy in high-resolution Optical Coherence Tomography
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Published: | June 29, 2009 |
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Purpose: To investigate longitudinal changes due to geographic atrophy in high-resolution optical coherence tomography (OCT) images, the fundus autofluorescence (FAF) pattern, and infrared images simultaneously recorded with a novel combined OCT-scanning laser ophthalmology (SLO) system.
Methods: Patients aged over 50 years with age-related macular degeneration (ARMD) and drusenoid PED develop often areas of geographic atrophy.These patients were assessed in a 2 year prospective longitudinal study by means of simultaneous spectral OCT-SLO (Spectralis HRA+OCT; Heidelberg Engineering, Heidelberg, Germany). The integrity of the retinal layers was analyzed in the apparently normal areas, the junctional zone between the normal retina and the geographic atrophy, and the atrophic area. The presence and integrity of the external limiting membrane, the photoreceptor inner segments, the outer segments, and the retinal pigment epithelium were assessed.
Results: Seventy-two eyes of 43 patients aged 57 to 92 years were examined. Morphological changes, retinal layer alterations were documented over 2 years, not only in atrophic zones, but also in junctional zones surrounding the geographic atrophy. Disintegration of the retinal layers began in the RPE and adjacent retinal layers, such as the photoreceptor inner and outer segments and external limiting membrane.
Conclusions: Novel imaging modalities will provide further valuable insight into ARMD pathogenesis. The key to understanding the morphologic change lies in in vivo depiction of retinal layers by spectral OCT technology in combination with other imaging modalities such as FAF.