The role of optical coherence tomography (OCT) in retinal and choroidal pathology with a focus on intravitreal anti-vascular endothelial growth factor therapy

Optical coherence tomography (OCT) is an imaging method for non-invasive, in vivo visualisation of the choroid and retina. The advent of OCT has greatly contributed to the understanding of disease mechanisms in retinal and choroidal pathology. It is used in clinical practice and in the management of intravitreal therapy. We contributed novel findings on choroidal nodules, peripapillary retinal nerve fibre alterations, and retinal microvascular changes in neurofibromatosis type 1 (NF1) using OCT. Furthermore, we studied the relationship of choroidal thickness on individual retinal layer thicknesses in NF1 and the Sturge Weber syndrome. We reported on macular thickness changes following cataract surgery using OCT and the use of intravitreal dexamethasone therapy as a therapeutic option in clinically significant macular oedema. Moreover, we used OCT to study the effects of anti-vascular endothelial growth factor (anti-VEGF) therapy in myopic choroidal neovascularisation and retinal angiomatous proliferation. Our studies informed the ongoing clinical debate regarding the management of these pathologies. Furthermore, as anti-VEGF therapy can theoretically affect the neural components of the retina, we reported that repeated treatment with ranibizumab does not cause significant thickness alterations of the ganglion cell complex. Finally, we demonstrated that the treatment of choroidal metastases with anti-VEGF therapy (intravitreal bevacizumab) resulted in tumour regression and resolution of macular oedema. In conclusion, we acquired an improved understanding of ophthalmologic pathologies that contributed to the development of better therapies for ophthalmologic patients through the use of OCT.