Fluorescein Angiography or Optical Coherence Tomography Angiography – Advantages and Defects of Neovascular Age-related Macular Degeneration Imaging

Wydanie 2/2018
str. 40 – 45

Autorzy: Małgorzata Figurska, Beata Pawlik, Marek Rękas

Klinika Okulistyki Wojskowego Instytutu Medycznego, Centralny Szpital Kliniczny Ministerstwa Obrony Narodowej w Warszawie
Kierownik: prof. dr hab. n. med. Marek Rękas

Summary: Fluorescein angiography has been the gold standard for macular imaging until the optical coherence tomography technology has disseminated into clinical practice. Nevertheless, it is an invasive procedure that requires intravenous dye administration. Photos of the fundus are performed up to several minutes after dye injection. Fluorescein angiography is a dynamic method of retinal assessment and the images obtained in different phases of the study differ. Fluorescein angiography allows the detection of neovascularization or other vascular pathologies, but the dye diffusion and intense background fluorescence in the later phases of the study obscure the details, for example the limits of the neovascularization lesions.

Optical coherence tomography angiography in its methodology is derived from en face optical coherence tomography and at the same time is a new technique of visualization and assessment of blood flow in retinal vessels and choroidal capillaries without the dye use. It is a static diagnostic method in which blood flow in vessels is detected at any time and it has static character. The article presents the principles of optical coherence tomography angiography, the characteristics of particular types of neovascularization, neovascularization patterns. The effect of anti-vascular endothelial growth factor therapy on optical coherence tomography angiography images was discussed.

In summary, the ability of optical coherence tomography angiography to noninvasively acquire information about choroidal neovascular membrane structure and flow in pathological vessels makes this method replace in most cases fluorescein and indocyanine angiography in routine diagnostics of patients with age-related macular degeneration.