OCT continues to offer optometrists unprecedented insight into ocular structures, and it’s got the added benefit of being a noninvasive option. Researchers in California are now saying that spectral-domain (SD)-OCT can best an older technology—fluorescein angiography—at yet another task.

For patients with neovascular AMD, SD-OCT can be used just as reliably as FA, the researchers said in their study. However, they add that eye doctors may still opt to use FA for patients with occult lesions that appear quiescent on SD-OCT, as this type of lesion may show leakage on FA.

The investigators looked into the data of the Post Hoc Analysis of Prospective Clinical Trial (HARBOR) and found 1,094 cases (99.9%) had baseline agreement between SD-OCT and FA in detecting choroidal neovascularization (CNV) activity. By month 24, of the 779 total active cases, the agreement was only 36%, and 58% of cases showed evidence of CNV activity on SD-OCT only. Only 6% showed CNV activity on FA only.

The study also shows the large majority of cases identified by FA only were occult CNV lesions.

Khurana R, Hill L, Ghanekar A, Gune S. Agreement of spectral domain optical coherence tomography with fluorescein leakage in neovascular age-related macular degeneration: post hoc analysis of the HARBOR study. Ophthalmol. April 27, 2020. [Epub ahead of print].