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OCT-Angiographie bei der exsudativen altersbedingten Makuladegeneration

Erste Erfahrungen

OCT angiography for exudative age-related macular degeneration

Initial experiences

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Zusammenfassung

Die neue Technik der OCT-Angiographie ermöglicht nichtinvasiv innerhalb von Sekunden eine dreidimensionale Rekonstruktion der gesamten vaskulären Strukturen der Netzhaut und Aderhaut. Noch ist diese Technik durch Bewegungsartefakte, Überlagerungen und zu entwickelnde dreidimensionale Abbildungsmodalitäten in ihrem letztendlichen Potenzial begrenzt. Erste Erfahrungen und Korrelationen mit Befunden in dem bisherigen Standarddiagnoseverfahren der Fluoreszenzangiographie und der Spektral-Domänen optische Kohärenztomographie (SD-OCT) zeigen, dass durch diese Technik neue Erkenntnisse zur Struktur vaskulärer und neovaskulärer retinaler Veränderungen gewonnen werden können. Hierbei müssen für dreidimensionale Gefäßveränderungen, wie sie z. B. bei der exsudativen altersbedingten Makuladegeneration (AMD) vorliegen, noch diagnostische Strategien evaluiert und festgelegt werden. Erste Befunde deuten darauf hin, dass die fluoreszenzangiographische Charakterisierung verschiedener CNV (choroidale Neovaskularisation)-Typen [spezifisch von Typ-1- (okkult) und Typ-2- (klassisch)-CNV] auch in der OCT-Angiographie wiedergefunden werden kann. Darüber hinaus können zusätzliche Informationen über die assoziierten Veränderungen in der Aderhaut und äußeren Netzhaut gewonnen werden, die zu einem besseren Verständnis dieser Pathologien führen können.

Abstract

The new technique of optical coherence tomography (OCT) angiography allows a non-invasive reconstruction of the three-dimensional structure of the total retinal and choroidal vascularization within seconds. There are still limitations caused by movement artefacts, superimposition of superficial retinal vessels at the retinal pigment epithelium (RPE) level and insufficient three-dimensional imaging modalities. Initial experiences with this new method and especially the correlation with the current standard diagnostic procedure of fluorescein angiography show that new information can be obtained regarding specific vascular and neovascular changes. For three-dimensional neovascular changes, such as those found in exudative age-related macular degeneration (AMD,) a more sophisticated diagnostic analysis strategy must be specifically developed. Initial experiences demonstrate that the differentiation into the various types of choroidal neovascularization (CNV) by fluorescein angiography, specifically for type 1 (occult) and type 2 (classical) can also be visualized by OCT angiography. Furthermore, the new technology provides additional information on the choroidal and outer retinal changes associated with this disease, which may result in a better understanding of the underlying pathology.

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Authors and Affiliations

  1. Augenabteilung, St. Franziskus Hospital Münster, Hohenzollernring 74, 48145, Münster, Deutschland

    A. Lommatzsch, M.-L. Farecki, B. Book, B. Heimes & D. Pauleikhoff

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  1. A. Lommatzsch
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  2. M.-L. Farecki
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  3. B. Book
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  4. B. Heimes
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  5. D. Pauleikhoff
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Correspondence to A. Lommatzsch.

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Interessenkonflikt

A. Lommatzsch, M.-L. Farecki, B. Book, B. Heimes und D. Pauleikhoff geben an, dass kein Interessenkonflikt besteht.

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Lommatzsch, A., Farecki, ML., Book, B. et al. OCT-Angiographie bei der exsudativen altersbedingten Makuladegeneration. Ophthalmologe 113, 23–29 (2016). https://doi.org/10.1007/s00347-015-0215-3

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  • DOI: https://doi.org/10.1007/s00347-015-0215-3

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