To identify best clinical practices for macular degeneration imaging.
Methods:
We reviewed best clinical practices for imaging patients with age-related macular degeneration. These recommendations are based on different levels of evidence (I-III).
Results:
The type of imaging needed depends to some degree on the clinical scenario: first visit vs follow-up visit vs poorly responsive patient.
Conclusions:
Imaging technologies that may be useful include optical coherence tomography, fundus photography, fundus autofluorescence imaging, fluorescein angiography, indocyanine green angiography, and optical coherence tomography angiography.
The periodic health examination. Canadian task force on the periodic health examination. Can Med Assoc J. 1979;121(9):1193–1254.
2.
ZarbinMA. Challenges in applying the results of clinical trials to clinical practice. JAMA Ophthalmol. 2016;134(8):928–933. doi:10.1001/jamaophthalmol.2016.1266
3.
Laser photocoagulation of subfoveal neovascular lesions in age-related macular degeneration. Results of a randomized clinical trial. Macular Photocoagulation Study Group. Arch Ophthalmol. 1991;109(9):1220–1231. doi:10.1001/archopht.1991.01080090044025
4.
BlinderKJBradleySBresslerNM. Effect of lesion size, visual acuity, and lesion composition on visual acuity change with and without verteporfin therapy for choroidal neovascularization secondary to age-related macular degeneration: TAP and VIP report no. 1. Am J Ophthalmol. 2003;136(3):407–418. doi:10.1016/S0002-9394(03)00223-X
5.
RosenfeldPJBrownDMHeierJS. Ranibizumab for neovascular age-related macular degeneration. N Engl J Med. 2006;355(14):1419–1431. doi:10.1056/NEJMoa054481
6.
BrownDMKaiserPKMichelsM. Ranibizumab versus verteporfin for neovascular age-related macular degeneration. N Engl J Med. 2006;355(14):1432–1444. doi:10.1056/NEJMoa062655
7.
FungAELalwaniGARosenfeldPJ. An optical coherence tomography-guided, variable dosing regimen with intravitreal ranibizumab (Lucentis) for neovascular age-related macular degeneration. Am J Ophthalmol. 2007;143(4):566–583. doi:10.1016/j.ajo.2007.01.028
8.
MartinDFMaguireMGYingGS. Ranibizumab and bevacizumab for neovascular age-related macular degeneration. N Engl J Med. 2011;364(20):1897–1908. doi:10.1056/NEJMoa1102673
9.
Comparison of Age-related Macular Degeneration Treatments Trials (CATT) Research Group, MartinDFMaguireMG. Ranibizumab and bevacizumab for treatment of neovascular age-related macular degeneration: two-year results. Ophthalmology. 2012;119(7):1388–1398. doi:10.1016/j.ophtha.2012.03.053
10.
JaffeGJMartinDFTothCA. Macular morphology and visual acuity in the Comparison of Age-related Macular Degeneration Treatments Trials. Ophthalmology. 2013;120(9):1860–1870. doi:10.1016/j.ophtha.2013.01.073
11.
Ben MoussaNGeorgesACapuanoVMerleBSouiedEHQuerquesG. MultiColor imaging in the evaluation of geographic atrophy due to age-related macular degeneration. Br J Ophthalmol. 2015;99(6):842–847. doi:10.1136/bjophthalmol-2014-305643
12.
SpaideRFCurcioCA. Drusen characterization with multimodal imaging. Retina. 2010;30(9):1441–1454. doi:10.1097/IAE.0b013e3181ee5ce8
13.
ZarbinMACasaroli-MaranoRPRosenfeldPJ. Age-related macular degeneration: clinical findings, histopathology, imaging techniques. In: Casaroli-MaranoRPZarbinMA, eds. Cell-Based Therapy for Retinal Degenerative Disease. Basel, Switzerland: Karger Medical and Scientific Publishers; 2014:1–32. doi:10.1159/000358536
14.
SleimanKVeerappanMWinterKP. Optical coherence tomography predictors of risk for progression to non-neovascular atrophic age-related macular degeneration. Ophthalmology. 2017;124(12):1764–1777. doi:10.1016/j.ophtha.2017.06.032
15.
FarsiuSChiuSJO’ConnellRV. Quantitative classification of eyes with and without intermediate age-related macular degeneration using optical coherence tomography. Ophthalmology. 2014;121(1):162–172. doi:10.1016/j.ophtha.2013.07.013
16.
FleckensteinMSchmitz-ValckenbergSAdrionC. Tracking progression with spectral-domain optical coherence tomography in geographic atrophy caused by age-related macular degeneration. Invest Ophthalmol Vis Sci. 2010;51(8):3846–3852. doi:10.1167/iovs.09-4533
17.
NunesRPGregoriGYehoshuaZ. Predicting the progression of geographic atrophy in age-related macular degeneration with SD-OCT en face imaging of the outer retina. Ophthalmic Surg Lasers Imaging Retina. 2013;44(4):344–359. doi:10.3928/23258160-20130715-06
18.
NagielASarrafDSaddaSR. Type 3 neovascularization: evolution, association with pigment epithelial detachment, and treatment response as revealed by spectral domain optical coherence tomography. Retina. 2015;35(4):638–647. doi:10.1097/IAE.0000000000000488
19.
QuerquesGSouiedEHFreundKB. How has high-resolution multimodal imaging refined our understanding of the vasogenic process in type 3 neovascularization?Retina. 2015;35(4):603–613. doi:10.1097/IAE.0000000000000487
20.
SaddaSRGuymerRHolzFG. Consensus definition for atrophy associated with age-related macular degeneration on OCT: classification of atrophy report 3. Ophthalmology. 2018;125(4):537–548. doi:10.1016/j.ophtha.2017.09.028
21.
HolzFGSaddaSRStaurenghiG. Imaging protocols in clinical studies in advanced age-related macular degeneration: recommendations from classification of atrophy consensus meetings. Ophthalmology. 2017;124(4):464–478. doi:10.1016/j.ophtha.2016.12.002
22.
FreundKBZweifelSAEngelbertM. Do we need a new classification for choroidal neovascularization in age-related macular degeneration?Retina. 2010;30(9):1333–1349. doi:10.1097/IAE.0b013e3181e7976b
23.
DansinganiKKGal-OrOSaddaSRYannuzziLAFreundKB. Understanding aneurysmal type 1 neovascularization (polypoidal choroidal vasculopathy): a lesson in the taxonomy of ‘expanded spectra’—a review. Clin Exp Ophthalmol. 2018;46(2):189–200. doi:10.1111/ceo.13114
24.
HolzFGBindewald-WittichAFleckensteinMDreyhauptJSchollHPSchmitz-ValckenbergS. Progression of geographic atrophy and impact of fundus autofluorescence patterns in age-related macular degeneration. Am J Ophthalmol. 2007;143(3):463–472. doi:10.1016/j.ajo.2006.11.041
Hope-RossMYannuzziLAGragoudasES. Adverse reactions due to indocyanine green. Ophthalmology. 1994;101(3):529–533. doi:10.1016/S0161-6420(94)31303-0
29.
OlsenTWLimJICaponeAJrMylesRAGilmanJP. Anaphylactic shock following indocyanine green angiography. Arch Ophthalmol. 1996;114(1):97. doi:10.1001/archopht.1996.01100130093018
30.
GuyerDRYannuzziLASlakterJS. Classification of choroidal neovascularization by digital indocyanine green videoangiography. Ophthalmology. 1996;103(12):2054–2060. doi:10.1016/S0161-6420(96)30388-6
31.
JiaYBaileySTWilsonDJ. Quantitative optical coherence tomography angiography of choroidal neovascularization in age-related macular degeneration. Ophthalmology. 2014;121(7):1435–1444. doi:10.1016/j.ophtha.2014.01.034
32.
KuehleweinLBansalMLenisTL. Optical coherence tomography angiography of type 1 neovascularization in age-related macular degeneration. Am J Ophthalmol. 2015;160(4):739–748.e2. doi:10.1016/j.ajo.2015.06.030
33.
KuehleweinLSaddaSRSarrafD. OCT angiography and sequential quantitative analysis of type 2 neovascularization after ranibizumab therapy. Eye (Lond). 2015;29(7):932–935. doi:10.1038/eye.2015.80
34.
El AmeenACohenSYSemounO. Type 2 neovascularization secondary to age-related macular degeneration imaged by optical coherence tomography angiography. Retina. 2015;35(11):2212–2218. doi:10.1097/IAE.0000000000000773
35.
de Oliveira DiasJRZhangQGarciaJMB. Natural history of subclinical neovascularization in nonexudative age-related macular degeneration using swept-source OCT angiography. Ophthalmology. 2018;125(2):255–266. doi:10.1016/j.ophtha.2017.08.030
36.
FaridiAJiaYGaoSS. Sensitivity and specificity of OCT angiography to detect choroidal neovascularization. Ophthalmol Retina. 2017;1(4):294–303. doi:10.1016/j.oret.2017.02.007
37.
TothCADecroosFCYingGS. Identification of fluid on optical coherence tomography by treating ophthalmologists versus a reading center in the Comparison of Age-related Macular Degeneration Treatments Trials. Retina. 2015;35(7):1303–1314. doi:10.1097/IAE.0000000000000483
38.
LumbrosoBRispoliMSavastanoMCJiaYTanOHuangD. Optical coherence tomography angiography study of choroidal neovascularization early response after treatment. Dev Ophthalmol. 2016;56:77–85. doi:10.1159/000442782
39.
SpaideRF. Optical coherence tomography angiography signs of vascular abnormalization with antiangiogenic therapy for choroidal neovascularization. Am J Ophthalmol. 2015;160(1):6–16. doi:10.1016/j.ajo.2015.04.012
40.
MuakkassaNWChinATde CarloT. Characterizing the effect of anti-vascular endothelial growth factor therapy on treatment-naive choroidal neovascularization using optical coherence tomography angiography. Retina. 2015;35(11):2252–2259. doi:10.1097/IAE.0000000000000836
41.
StewartMWRosenfeldPJPenhaFM. Pharmacokinetic rationale for dosing every 2 weeks versus 4 weeks with intravitreal ranibizumab, bevacizumab, and aflibercept (vascular endothelial growth factor Trap-eye). Retina. 2012;32(3):434–457. doi:10.1097/IAE.0B013E31822C290F
42.
ImamuraYFujiwaraTMargolisRSpaideRF. Enhanced depth imaging optical coherence tomography of the choroid in central serous chorioretinopathy. Retina. 2009;29(10):1469–1473. doi:10.1097/IAE.0b013e3181be0a83
43.
FerraraDMohlerKJWaheedN. En face enhanced-depth swept-source optical coherence tomography features of chronic central serous chorioretinopathy. Ophthalmology. 2014;121(3):719–726. doi:10.1016/j.ophtha.2013.10.014
44.
De FauwJKeanePTomasevN. Automated analysis of retinal imaging using machine learning techniques for computer vision. F1000Res. 2016;5:1573[revised June 22, 2017]. doi:10.12688/f1000research.8996.2
45.
PoplinRVaradarajanAVBlumerK. Prediction of cardiovascular risk factors from retinal fundus photographs via deep learning. Nat Biomed Eng. 2018;2:158–164. doi:10.1038/s41551-018-0195-0
46.
BogunovićHWaldsteinSMSchleglT. Prediction of anti-VEGF treatment requirements in neovascular AMD using a machine learning approach. Invest Ophthalmol Vis Sci. 2017;58(7):3240–3248. doi:10.1167/iovs.16-21053
