247
Figure 17.
(A) Central hard drusen surrounded by atrophic areas of the RPE are seen in the retinography. (B) In the autofluores-
cence image, a hypofluorescence area corresponding to atrophic areas of the RPE may be apreciated. (C) In the OCT, two hyper-
reflectant points corresponding to hard drusen observed in the retinography are seen. (D) Infrared image captured by the OCT
which shows the tomographic section line of figure C.
16. WET AMD
Retinal study using OCT is now a fundamental tool to
manage patients with wet AMD. Since the introduction
of PDT as an antiangiogenic agent a decade ago, OCT
has provided information on the activity of neovascular
membranes and determines the need to establish treat-
ment, treatment response, and early signs of recurrence
or resolution. The importance of this was that several
multicenter studies were designed to evaluate treatment
protocols of antiangiogenic therapies that rely on OCT
as the main criteria for retreatment. This opened the
door to development of treatment protocols determined
by OCT such as those raised in the following studies to
optimize treatment regimens in these patients.
PrONTO Study (Prospective Optical Coherence
Tomography Imaging of Patients with Neovascular
Age-Related Macular Degeneration Treated with
intraOcular Ranibizumab):
The injection protocols
established in multicenter phase III studies of ranibi-
zumab for neovascular AMD, the ANCHOR and
MARINA trials, consisted of monthly intravitreal injec-
tions for 2 years for all study eyes that resulted in sub-
stantial gains in VA in various intermediate controls and
at the final examination.
51-53
However, the dose of 24
injections carried a human and economic burden that
made it difficult and impractical to administer. In phase
I and II studies of ranibizumab before these studies, an
extension study was conducted in which administration
OPTICAL COHERENCE TOMOGRAPHY IN AGE-RELATED MACULAR DEGENERATION
