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Impressum
Intraoperative membrane size in macular rotation surgery in comparison to fluorescein angiographic findings in occult membranes
Walter A. F., Roider J.
Klinik und Poliklinik für Augenheilkunde der Universität Regensburg; Franz- Josef-Strauss-Allee 11, D-93053 Regensburg
Objective: The exact limitations of occult neovascularisation
membranes in age related macular degeneration are unknown, because analysis
of occult membranes is based on the size of leakage. By macular rotation
it is possible to study the in vivo situation of occult membranes. Aim
of this study is the comparison of the in vivo size of occult membranes
to the fluorescein angiographic leakage in the early and the late phase.
Methods: Retrospectively we could analyse the in vivo size of membranes
of 6 from 24 patients during macular rotation. The measurement of leaking
size was determined with the Heidelberg Retina Angiograph. To measure
the in vivo membrane size, we saved the relevant operation sequences as
digital images and determinated the membrane size in pixel. As a reference
size we took the diameter of instruments used during the operation and
determinated the size in pixel and in squaremillimeter.
Results: Three patients had similar size as obtained by in vivo
measurement and by measurement of the leaking size in fluorescein angiography
(19,3mm2 versus 19,0mm2/19,0mm2 (late/early phase), 7,9mm2 versus 7,10mm2/6,15mm2
and 6,1mm2 versus 6,3mm2 (late phase)). Two patients had a larger size
in vivo (12,5mm2 versus 10,0mm2/2,4mm2 (late/early phase) and 8,1mm2 versus
4,3mm2/4,0mm2). One patient had a smaller in vivo membrane size compared
to the fluorescein angiographic leakage (2,7mm2 versus 6,2mm2/4,4mm2 (late/early
phase)). Because of the different axial location of the instruments the
real size of membranes is approximately 10 to 20 percent larger than the
determinated membrane size.
Conclusion: The absolute size of the membrane varies by a factor
of 0.5 to 2 compared to the leakage as seen in fluorescein angiography.
This results have to be considered in the laser treatment (e.g. PDT) of
occult membranes.