https://doi.org/10.1177/1120672118766807 European Journal of Ophthalmology 2018, Vol. 28(4) 349–357 © The Author(s) 2018 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/1120672118766807 journals.sagepub.com/home/ejo EJO European Journal of Ophthalmology Introduction Age-related macular degeneration (AMD) is the leading cause of irreversible central visual function impairment in developed countries among people above 50 years of age. 1–3 In the “early” AMD the fundamental feature is the deposition of a cellular polymorphous material, termed drusen, between the retinal pigment epithelium (RPE) and Bruch’s membrane (BM) and where focal retinal pigmen- tary abnormalities are also commonly seen. 3–9 Patients at this stage are often asymptomatic. Conversely, the devel- opment of “late” AMD is typically associated with central visual loss. 3,10 In late “dry” or “atrophic” AMD, the main Optical coherence tomography angiography in age-related macular degeneration: The game changer Marco Lupidi 1,2,3 , Alessio Cerquaglia 1 , Jay Chhablani 4 , Tito Fiore 1 , Sumit Randhir Singh 4 , Felice Cardillo Piccolino 3 , Roberta Corbucci 1 , Florence Coscas 2,5 , Gabriel Coscas 2,5 and Carlo Cagini 1 Abstract Optical coherence tomography angiography is one of the biggest advances in ophthalmic imaging. It enables a depth- resolved assessment of the retinal and choroidal blood flow, far exceeding the levels of detail commonly obtained with dye angiographies. One of the first applications of optical coherence tomography angiography was in detecting the presence of choroidal neovascularization in age-related macular degeneration and establishing its position in relation to the retinal pigmented epithelium and Bruch’s membrane, and thereby classifying the CNV as type 1, type 2, type 3, or mixed lesions. Optical coherence tomography angiograms, due to the longer wavelength used by optical coherence tomography, showed a more distinct choroidal neovascularization vascular pattern than fluorescein angiography, since there is less suffering from light scattering or is less obscured by overlying subretinal hemorrhages or exudation. Qualitative and quantitative assessments of optical coherence tomography angiography findings in exudative and nonexudative age-related macular degeneration have been largely investigated within the past 3 years both in clinical and experimental settings. This review constitutes an up-to-date of all the potential applications of optical coherence tomography angiography in age-related macular degeneration in order to better understand how to translate its theoretical usefulness into the current clinical practice. Keywords Optical coherence tomography angiography, age-related macular degeneration, choroidal neovascularization, exudative age-related macular degeneration Date received: 18 February 2018; accepted: 5 March 2018 1 Department of Biomedical and Surgical Sciences, Section of Ophthalmology, University of Perugia, S. Maria della Misericordia Hospital, Perugia, Italy 2 Centre de l’Odéon, Paris, France 3 The Macula Onlus Foundation, Genova, Italy 4 Department of Smt Kanuri Santhamma Centre for Vitreo Retinal Diseases, LV Prasad Eye Institute, Hyderabad, India 5 Department of Ophthalmology, Centre Hospitalier Intercommunal de Créteil, Université Paris-Est, Créteil, France Corresponding author: Gabriel Coscas, Department of Ophthalmology, Centre Hospitalier Intercommunal de Créteil, Université Paris-Est, 40 Avenue de Verdun, 94000 Créteil, France. Email: gabriel.coscas@gmail.com 766807EJO 0 0 10.1177/1120672118766807European Journal of OphthalmologyLupidi et al. review-article 2018 Review