Role of Optical Coherence Tomography Angiography in the Diagnosis and Management of Wet Age-Related Macular Degeneration

Abstract

Background Neo-vascular age-related macular degeneration (nAMD) (an advanced form of macular degeneration) is the main cause of visual impairment in older adults related to AMD. WHO has estimated that approximately 8 million people will be affected by AMD by the year 2020. Optical coherence tomography angiography (OCTA) is a novel imaging modality that permits direct visualization of the retinal and choroidal vasculature in vivo. In OCTA, high-frequency and dense volumetric scanning are made to detect blood flow by analyzing the signal decorrelation between scans. Compared with stationary areas of the retina, the movement of erythrocytes within a vessel makes a decorrelated signal. Unlike traditional angiography, OCTA does not necessitate the use of exogenous dyes, so avoiding potential side effects, such as nausea or other more serious adverse events. However, the role of OCTA as a diagnostic tool has not been largely investigated. Particularly, very few clinical studies have assessed the accuracy of OCTA imaging for the diagnosis of nAMD. Aim of the Work To highlight the benefits of using OCT-A in the diagnosis and management of wet AMD and compare it with the conventional angiographic standard, fundus fluorescein angiography (FFA). Subjects and Methods An interventional prospective comparative study will be conducted on 40 eyes diagnosed with wet AMD. Optical coherence tomography angiography and FFA will be done for all eyes. Analysis of the data obtained from the OCT-A will be done and compared with the standard FFA. Conclusion AMD is the leading cause of vision loss. Early detection and treatment is required. AMD is diagnosed by fundus examination, FA, and OCTA. OCTA and FA imaging provide complementary information about pathological changes in chorioretinal diseases. OCTA is highly sensitive for identifying AMD, CNV, and CNV activity; however, it cannot fully replace FA in the diagnosis of AMD.