Grading of infrared confocal scanning laser tomography and video displays of digitized color slides in exudative age-related macular degeneration.

PURPOSE To detect and localize exudative lesions in exudative age-related macular degeneration and to compare images obtained from infrared scanning laser tomography and video displays of digitized color slides in detection and localization of exudation. METHODS In a prospective study, 11 eyes of 11 patients with exudative age-related macular degeneration were studied. From 32 images with infrared scanning laser tomography, confocal images were chosen in the following focal planes: anterior to the retina, the retinal surface, and the deep retina. Using the fluorescein angiogram as a standard, three retinal specialists rank-ordered the ability to discern the lesion in these confocal images, the summary of confocal images, and video displays of digitized color slides that were adjusted to the same resolution as that of the confocal images (approximately 23 microm per pixel). RESULTS For choroidal neovascularization, both the retinal surface image and the summary image were rated superior to video displays of digitized color slides (P < 0.004). The confocal images were ranked in the following fashion: best, retinal surface; next, deep retina; and then, anterior to the retina (P < 0.01). For pigment epithelial detachment, all three confocal images and summary images were superior to video displays of digitized color slides (P < 0.002). There were no significant differences among the confocal images (P = 0.95). CONCLUSION Infrared confocal imaging was superior to video displays of digitized color slides for visualization of both pigment epithelial detachment and choroidal neovascularization. This technique could have an impact on epidemiologic studies.