The use of confocal scanning laser tomography in the evaluation of retinalelevation in age-related macular degeneration

Objective: To evaluate the feasibility of using confocal scanning laser tom ography in the analysis of macular topography in patients with subfoveal ch oroidal neovascularization associated with age-related macular degeneration (AMD) and to analyze quantitatively the changes in topography after local strontium-plaque radiation therapy. Design: Prospective case series. Participants: A total of 16 eyes with subfoveal choroidal neovascular membr anes (CNVM) treated with strontium-90 (Sr-90)-plaque radiation therapy and 16 fellow eyes of 16 patients were examined. Intervention: Confocal scanning laser analysis of macular surface topograph y before and after irradiation of the macula was performed. Main Outcome Measures: Parameters describing the height and volume of the r etinal elevation in the macula were measured. Results: The maximum height of the macular lesion at baseline was 0.25 mm ( standard deviation [SD], 0.12 mm) in eyes showing regression of the CNVM du ring follow-up and 0.34 mm (SD, 0.19 mm) in eyes showing continued growth o f the CNVM, During follow-up, a mean decrease in the maximum height of the macular lesion ranging from 0.03 to 0.10 mm occurred in eyes with regressio n of the CNVM, whereas the mean maximum height increased by 0.07 to 0.15 mm during follow-up visits in eyes with continued growth of the CNVM, All par ameters describing the mean height and volume of the lesion also decreased significantly in patients showing angiographic regression, whereas they inc reased or remained unchanged in patients with continuous growth of the CNVM despite irradiation. The corresponding parameters also were higher in fell ow eyes with untreated CNVM than in eyes without exudative AMD. Conclusions: Confocal scanning laser tomography can be used to monitor the amount of and change in neurosensory detachment in AMD, The parameters obta ined by confocal scanning laser tomography correlate with CNVM perfusion af ter Sr-90-plaque radiation therapy. This technology is a useful tool for ob jective evaluation of morphologic change after institution of new therapeut ic methods for the treatment of AMD.