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Abdhish R Bhavsar; Incidence of CNV in Asymptomatic Fellow Eyes of Patients with Neovascular AMD. Invest. Ophthalmol. Vis. Sci. 2014;55(13):646.
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To determine the incidence of asymptomatic choroidal neovascularization (CNV) in fellow eyes of patients with neovascular age-related macular degeneration (AMD) under the care of a single surgeon in an active retina surgery practice.
Consecutive patients with neovascular AMD who were seen in the office by the same surgeon between April 18, 2011 and August 31, 2013 who had asymptomatic CNV in the fellow eye were noted. Demographic information, visual acuity in the fellow eye, new treatment initiated in the fellow eye, and treatment and visual acuity of the primary eye were noted.
There were 56 patients who developed CNV in their asymptomatic fellow eye out of 803 patients examined with exudative AMD over the study timeframe of approximately 16 months. The incidence of CNV in asymptomatic fellow eyes of patients with neovascular AMD was 7% in this series. Over 90% of the patients examined over the study timeframe presented for treatment of the eye that originally developed CNV. Most of these patients were receiving an anti-VEGF treatment in their primary eye during the course of follow up. In addition, the majority of the asymptomatic fellow eyes had new subretinal hemorrhage as a clinical sign of CNV. The median age of the patients who developed asymptomatic CNV was 79 years. The median visual acuity in the fellow eye was 20/80.
Asymptomatic CNV does develop in fellow eyes of neovascular AMD patients. Since earlier treatment is typically equated with better visual acuity outcomes, treating asymptomatic eyes at discovery of the CNV would seem logical. The incidence of asymptomatic CNV in fellow eyes is substantial enough to warrant bilateral complete retinal examination of all patients with neovascular AMD during each visit, even if they are presenting “only” for an injection in the eye that originally developed CNV.
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