Is spectral-domain optical coherence tomography essential for flexible treatment regimens with ranibizumab for neovascular age-related macular degeneration?

Purpose. to evaluate the ability of spectral-domain optical coherence tomography to detect subtle amounts of retinal fluid when the choroidal neovascularization is detected as inactive via time-domain optical coherence tomography and clinical examination in neovascular age-related macular degeneration (namd) patients. methods. forty-nine eyes of 49 patients with namd after ranibizumab treatment were included in this cross-sectional,prospective study. all patients were imaged with td-oct and sd-oct at the same visit one month after a ranibizumab injection. the presence of subretinal,intraretinal,and subretinal pigment epithelium fluid (subrpe) in sd-oct was evaluated; also mean central retinal thickness (crt) and the rate of vitreoretinal surface disorders detected via the two devices were evaluated. results. the mean crt via td-oct and sd-oct was 218.1±51.3 and 325.7±78.8 microns. sixteen patients (32.6%) showed any kind of retinal fluid via sd-oct. in detail,8 patients (16.3%) showed subretinal fluid,10 patients (20.4%) showed intraretinal fluid,and 3 patients (6.1%) showed subrpe fluid. the ability of detecting vitreoretinal surface disorders was comparable between the two devices,except vitreomacular traction. conclusion. sd-oct is essential for the namd patients who are on an as-needed treatment regimen with ranibizumab. only td-oct and clinical examination may cause insufficient treatment in this group of patients. © 2013 abdullah ozkaya et al.