COPENHAGEN — OCT angiography is establishing itself as a reliable, easy to perform, noninvasive tool for the evaluation of disease progression and treatment-related improvement in retinal diseases such as age-related macular degeneration, diabetic retinopathy and retinal vein occlusion.
“Two studies, one published by our group and one by the group of David Sarraf, have recently demonstrated that the information and results provided by OCTA and fluorescein angiography are virtually the same. This is a very important achievement because we have proved that we can trust the method,” Gabriel Coscas, MD, said at the Euretina meeting.
A lot of effort has been made to understand and overcome the artifacts and pitfalls of OCTA.
“There are pitfalls and errors with fluorescein angiography, but we have learned over many years how to deal with them. Now we are learning to do the same with OCTA,” he said.
The first lesson learned was that automatic segmentation must be avoided, at least in difficult cases, in favor of manual segmentation. The second lesson was that thin sections of no more than 30 µm are necessary to clearly visualize, and not confuse, the different vascular layers.
“The third conclusion we reached now is that this technique will improve patient compliance with frequent visits because it is noninvasive and comfortable. This will allow us to treat the patients at the early stage of any recurrence and not when the recurrence has progressed to loss of vision, which is always partially irreversible,” Coscas said.
By providing quantitative evaluation of the disease and its progression, OCTA is also a valid prognostic tool to predict the future result of the treatment and to give good indications for the schedule of treatment, he said. – by Michela Cimberle
Disclosure: Coscas reports he is a member of the advisory board of Allergan, Novartis, Bayer and Heidelberg Engineering.