ICG analysis of choroidal neovascularization in AMD treated with ranibizumab suggests that there is minimal effect on the actual choroidal neovascularization despite reduction in exudation. The preliminary one year results showed only a 5% change in the mean size of the choroidal neovascular membrane as graded with indocyanine green angiography (unpublished data). MinIpOCT is a novel algorithm that identifies and displays the minimum optical intensity found between the internal limiting membrane and retinal pigment epithelium. The software was initially developed to provide an en face fundus image where fluid presented as dark regions. Surprisingly, bright areas were also noted and these seem to correspond to the outer retinal area overlying the choroidal neovascularization. The one year results showed a mean 6% increase in the area of outer retinal change noted with minIpOCT (unpublished data). These data suggest that anti-VEGF treatment in the form of ranibizumab has mininal effect on the culprit choroidal neovascularization itself. This provides useful data to assess other potential neovascular age related macular degeneration treatments.

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