Occult Chorioretinal Anatomoi in Age-Related Macular Degeneration: A Propective tudy by Optical Coherence Tomography

Purpoe To invetigate macular optical coherence tomography (OCT) feature in patient with chorioretinal anatomoi (CRA) and druen, a well a their correlation with the Ga occult-CRA hypothei. Deign Propective obervational cae erie. Method etting: Tertiary ophthalmic referral center. tudy population: All patient with biomicrocopic evidence of CRA and druen conecutively evaluated between February 2003 and March 2004. obervation procedure: Third-generation OCT evaluation and tereocopic angiographic tudie. main outcome meaure: Macular morphologic feature at baeline and at 12 week. Reult Twenty eye with CRA and druen were identified in 11 patient, even women (63.6%) and four men (36.4%) ranging in age from 69 to 82 year (median, 79 year). Focal elevation of the retinal pigment epithelium wa een in eye with tage 1 (pre-clinical) CRA. mall hyperreflective ignal at the level of the elevated retinal pigment epithelium were een in tage 2 CRA. In tage 3 CRA, a hyperreflective “mound” at the level of the elevated retinal pigment epithelium wa een in aociation with a thickened retina. In tage 4 CRA ub-retinal pigment epithelium fluid accumulation wa preent, and complete diorganization of the macular region wa oberved in tage 5 CRA. Macular change were oberved in eight eye (40%) at follow-up, with all but one CRA leion progreing one tage. Concluion Morphologic feature and change demontrated by OCT ugget that fibrovacular detachment of the retinal pigment epithelium followed by development of occult CRA are the initial event occurring in eye with CRA in age-related macular degeneration. Our finding may upport the evolutionary CRA taging ytem propoed by Ga.