Optical coherence tomography angiography (OCTA) is a non-invasive retinal imaging innovation that has been gaining popularity for the evaluation of the retinal vasculature. Of clinical importance is its current use either as an alternative or in conjunction with conventional dye-based angiography in neovascular age-related macular degeneration. OCTA is not without limitations and these include image artefact, a relatively small field of view and failure of the segmentation algorithms, which can confound the interpretation of findings. While there are numerous publications on OCTA in neovascular AMD, few have examined the diagnostic accuracy of this new technology compared with the accepted gold standard of fundus fluorescein angiography (FFA). In this review, we summarise the literature on the clinical application of OCTA in nAMD. In particular, we have reviewed the published articles that have reported the sensitivity and specificity of OCTA in the diagnosis of nAMD, and those that have described and or correlated the morphological findings and compared them to dye-based angiography.

A 57-year-old man was referred with a 1-month history of leg swelling, myalgia, and generalized weakness. This had been preceded by 2 weeks of sore throat, treated with aspirin and erythromycin. His past medical history included hypercholesterolemia, for which he was prescribed pravastatin. His baseline creatinine recorded 1 year previously was 90 mmol/l, but on this admission it was elevated at 152 mmol/l. He worked in the construction industry, and his occupational history was notable for having been employed extensively in Eastern Europe and Russia in the 1980s. This included close proximity to the Chernobyl Power Plant at the time of the nuclear accident in 1986.He had been admitted to another hospital 3 weeks earlier with similar symptoms. At that time, the creatinine was 146 mmol/l and serum creatine kinase (CK) was 4659 IU/l. Corrected serum calcium was 2.16 mmol/l and phosphate was 1.30 mmol/l. Intravenous fluids were administered, and he was advised to discontinue all medications. Nonetheless, a repeat CK 2 weeks later was further elevated at 11,000 IU/l, precipitating referral to our unit.The patient was euvolemic on physical examination, and his blood pressure was 125/85 mm Hg. Electromyography, magnetic resonance imaging of the legs, positron emission tomography-computed tomography, and ultrasound of the renal tract were normal, as were urine toxicology and an acute virology screen. Anti-streptolysin O and anti-nuclear antibody titres were weakly elevated, although anti-doublestranded DNA antibodies, extractable nuclear antigens, and myositis antibodies (Jo-1, PL-7, PL-12, SRP, Ku, Mi-2, and Pm/SCl) were not detected. Complement levels were normal.