title: Combined fluorescein angiography and spectral-domain optical coherence tomography imaging of classic choroidal neovascularization secondary to age-related macular degeneration before and after intravitreal ranibizumab injections.
abstract: OBJECTIVE
  To evaluate the combined fluorescein angiography and spectral-domain optical coherence tomography features in a consecutive series of exudative age-related macular degeneration eyes with classic choroidal neovascularization before and after anti-vascular endothelial growth factor treatment.
  
  
  METHODS
  Retrospective interventional study. All consecutive patients with exudative age-related macular degeneration because of newly diagnosed classic choroidal neovascularization visited during 3 months and treated by intravitreal ranibizumab injection on "as-needed" basis were analyzed. Combined fluorescein angiography and spectral-domain optical coherence tomography examination (Spectralis Heidelberg Retina Angiograph OCT) was performed at baseline and at the 12-month follow-up visit.
  
  
  RESULTS
  Twenty-nine treatment-naive eyes (29 patients, 10 men and 19 women, mean age 76.28 ± 10.86 years) were included. A mean of 5.3 ± 3.5 injections was administered during 12 months. At Month 12 visit, patients showed an improved best-corrected visual acuity (P = 0.01), a reduction of linear dimension of the entire lesion on fluorescein angiography (P = 0.02), and a reduction of the entire lesion width on spectral-domain optical coherence tomography (P < 0.001). At baseline, in all cases we distinguished on spectral-domain optical coherence tomography scan a highly reflective subretinal lesion, above and separate from the retinal pigment epithelium. The highly reflective subretinal lesion showed a significant reduction of width along the length of a single B-scan, at Month 12 follow-up visit (P < 0.001). It is notable that a small "discreet" pigment epithelial detachment associated with the highly reflective subretinal lesions was present in 28 of 29 eyes at baseline and after treatment (at Month 12 follow-up visit).
  
  
  CONCLUSIONS
  A discreet pigment epithelial detachment represents a common associated finding of classic choroidal neovascularization. Our study demonstrated that anti-vascular endothelial growth factor treatment may not only stop the growth of the highly reflective subretinal lesion that colocalize with the classic choroidal neovascularization but also determine its regression.
authors.affiliation: Department of Ophthalmology, Creteil Eye Clinic, University Paris Est Creteil, Creteil, France.
authors.forename: Florence
authors.initials: F
authors.lastname: Coscas
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Querques
authors.forename: Raimondo
authors.initials: R
authors.lastname: Forte
authors.forename: Celine
authors.initials: C
authors.lastname: Terrada
authors.forename: Gabriel
authors.initials: G
authors.lastname: Coscas
authors.forename: Eric H
authors.initials: EH
authors.lastname: Souied
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage*; D020256:Choroidal Neovascularization / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D005451:Fluorescein Angiography / Q000379:methods; D006801:Humans; D058449:Intravitreal Injections; D008268:Macular Degeneration / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D000069579:Ranibizumab; D012044:Regression Analysis; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence / Q000379:methods; D014792:Visual Acuity
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D000069579:Ranibizumab