Management of Anti-vascular Endothelial Growth Factor Therapy – Diagnostic Pitfalls
نویسندگان
چکیده
Age-related macular degeneration (AMD) is the leading cause of irreversible vision loss in adults aged over 50 years in developed countries. In 2006, the use of intravitreal injections of anti-vascular endothelial growth factor (anti-VEGF) drugs revolutionised the therapeutic approach to treating neovascular AMD. However, it is essential to detect the frequent diagnostic pitfalls encountered in this therapeutic domain to apply anti-VEGF therapy successfully and thereby avoid useless treatments. Classic pitfalls include – retinal pigmented epithelium-photoreceptor abnormalities mimicking choroidal neovascularisation; persistent serous retinal detachment; pseudocysts and cystoid cavities mimicking retinal oedema; and outer retinal tubulations. Current imaging technologies, such as colour fundus photography, autofluorescence (FAF) and infrared imaging, fluorescein (FA) and indocyanine green (ICGA) angiographies, spectral domain optical coherence tomography (SD-OCT) and enhanced depth imaging OCT (EDI-OCT), can help overcome these pitfalls. Even if anti-VEGF treatments are mostly based on SD-OCT data, the consolidation and correlational analysis of all the available patient data is essential for accurate diagnosis.
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