Association between foveal photoreceptor integrity and visual outcome in neovascular age-related macular degeneration

Am J Ophthalmol. 2009 Jul;148(1):83-9.e1. doi: 10.1016/j.ajo.2009.01.017. Epub 2009 Mar 27.

Abstract

Purpose: To evaluate the correlation between visual outcome and foveal photoreceptor integrity after successful treatment of eyes with neovascular age-related macular degeneration (AMD).

Design: Retrospective chart review.

Methods: We retrospectively studied the medical records of 51 eyes of 51 patients with neovascular AMD who were treated successfully with photodynamic therapy (PDT). All eyes were followed-up for more than 24 months after the initial treatment. Using spectral-domain optical coherence tomography, the status of the inner segment and outer segment (IS/OS) photoreceptor junction was assessed as a hallmark of the integrity of the foveal photoreceptor layer.

Results: At the final visit, no eyes showed an exudative change. A complete or discontinuous IS/OS line was detected beneath the fovea in 8 (15.7%) and 25 (29.4%) eyes, respectively, whereas 28 (54.9%) had no IS/OS line. Eyes with a continuous or discontinuous IS/OS line beneath the fovea had better final visual acuity (VA) than did eyes without an IS/OS line (P < .001, respectively). Of the 51 eyes, 36 showed polypoidal choroidal vasculopathy (PCV), whereas 15 were diagnosed as having typical AMD without PCV. Visual outcome was significantly better in eyes with PCV (P = .026). Most eyes (13/15; 86.7%) with typical AMD had no IS/OS line at the final visit, whereas only 13 (36.1%) of the 36 eyes with PCV had no IS/OS line beneath the fovea.

Conclusions: Integrity of the photoreceptor layer beneath the fovea is associated with the final VA in neovascular AMD after successful PDT.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Choroidal Neovascularization / drug therapy
  • Choroidal Neovascularization / physiopathology*
  • Coloring Agents
  • Female
  • Fluorescein Angiography
  • Follow-Up Studies
  • Fovea Centralis
  • Humans
  • Indocyanine Green
  • Macular Degeneration / drug therapy
  • Macular Degeneration / physiopathology*
  • Male
  • Middle Aged
  • Photochemotherapy
  • Retinal Photoreceptor Cell Inner Segment / pathology*
  • Retinal Photoreceptor Cell Outer Segment / pathology*
  • Retrospective Studies
  • Tomography, Optical Coherence
  • Treatment Outcome
  • Visual Acuity / physiology*

Substances

  • Coloring Agents
  • Indocyanine Green