Purpose: : to compare autofluorescence (AF) pattern of the retinal pigment epithelium in patients with choroidal neovascular membrane (CNV) due to age related macular degeneration (AMD) with the cross sectional images obtained by optical coherence tomography (OCT), visual acuity and type of CNV.
Methods: : 26 patients (16 females 11 males, mean age 83.11 years) with CNV due to AMD before and after the 3 load injections of an anti-VEGF agent were assessed with a complete ophthalmologic examination. AF images were taken using Heidelberg Retina Angiograph and the digital color photos, fluorescein angiogragraphy and Indocyanine Green Angiography (ICG) using the same TOPCON 501 camera.
Results: : The visual acuity ranged from 1.0 to 0.3 according to Snellen EDTRS chart with a mean of 0.45. 43% of eyes had previous cataract surgery. Classic and minimally choroidal neovascular membrane CNV was observed in 12 eyes, occult in 8 eyes and serous pigment epithelium detachment PED with occult component in 6 eyes. Normal, continuous autofluorescence AF was present in 24 and correlated with VA. In 11 eyes a normal autofluorescence AF at the fovea was associated with areas of hyperautofluorescence which correlated to a PED on OCT in 6 cases, to intraretinal fluid on OCT in 2 cases and to an occult CNV with normal OCT in 3 eyes. 23 eyes with intraretinal fluid (cysts) on OCT or mild sub retinal fluid did not have areas of hyperautofluorescence. There was no difference between patients who were naïve to anti VEGF treatment and those after a loading dose of 3 intravitreal injections.
Conclusions: : The presence of cystic type fluid accumulation on OCT (without PED) did not correlate to hyperautofluorescence in most of our cases, indicating a normal photoreceptor outer segment turn over and a proper phagocytosis of the RPE in our early stages CNVs. The RPE-AF in exudative AMD might have a prognostic value as to the outcome of the anti-VEGF treatment. However, further longitudinal studies are required to confirm this hypothesis.