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Research Letters |

Effect of Intravitreous Anti–Vascular Endothelial Growth Factor Therapy on Choroidal Thickness in Neovascular Age-Related Macular Degeneration Using Spectral-Domain Optical Coherence Tomography

Lauren Branchini, MD; Caio Regatieri, MD, PhD; Mehreen Adhi, MBBS; Ignacio Flores-Moreno, MD; Varsha Manjunath, MD; James G. Fujimoto, PhD; Jay S. Duker, MD
JAMA Ophthalmol. 2013;131(5):693-694. doi:10.1001/jamaophthalmol.2013.692.
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Extract

A critical method of monitoring patients with neovascular age-related macular degeneration (AMD) being treated with anti–vascular endothelial growth factor (anti-VEGF) is optical coherence tomography (OCT), which uses low-coherence interferometry of light to examine the retina in vivo on a micrometer scale.1

Recent advances in spectral-domain OCT make visualization of the choroid feasible. Using image averaging and enhanced depth imaging, successful examination and measurement of choroidal thickness in normal and pathologic states have been reported.24

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Figure 1. Spectral-domain optical coherence tomographic scans showing choroidal thicknesses of the same subject at 4 different times. Image averaging is used for choroidal visualization. Subfoveal choroidal thickness measurements were taken from the outer edge of the hyperreflective retinal pigment epithelium to the inner sclera. Red lines indicate subfoveal choroidal thickness. A, Before treatment with intravitreous anti–vascular endothelial growth factor. B, Three months after treatment with intravitreous anti–vascular endothelial growth factor. C, Six months after treatment with intravitreous anti–vascular endothelial growth factor. Note the decrease in choroidal thickness. D, Twelve months after treatment with intravitreous anti–vascular endothelial growth factor. Note the decrease in choroidal thickness.

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Figure 2. Mean choroidal thickness over all locations measured in 500-μm intervals, 2500 μm temporal (T) and nasal (N) to the fovea before treatment and 3, 6, and 12 months after the first treatment. Note that the N measurements are thinnest where the T measurements are thickest. The numbers next to the T and N locations indicate millimeters.

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