Differential diagnosis of various types of fluids on the eye fundus in patients with age-related macular degeneration

Abstract

Age-related macular degeneration (AMD) is a leading cause of vision loss both worldwide and in Russia. A distinctive feature of the exudative form of AMD is the presence of choroidal neovascularization (CNV) as a result of pathological angiogenesis of the choroid. With the introduction of optical coherence tomography (OCT) - a non-invasive imaging technique - it has become possible to monitor CNV activity. In the development of CNV, OCT can reveal three types of fluid localization: intraretinal fluid (IRF), subretinal fluid, fluid under retinal pigment epithelium (RPE). Exudative IRF is characterized by the presence of round and/or oval space. This type of fluid is characterized by good response to anti-VEGF therapy. Degenerative IRF («cystoid degeneration») is characterized as a small, clearly defined hyporeflective spaces above the area with altered RPE not responding to anti-VEGF therapy. Thus, early diagnosis of AMD and detection of «new activity» after therapy with antivascular endothelial growth factor (anti-VEGF) by comparing distribution of the fluid in SD-OCT are critical to maintaining or restoring the best possible visual acuity in patients with this disease.