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Nicholas Tosi, Mahdi Basha, Allison Babiuch, Geremie Palombaro, Gary Brown; No Light Perception Incidence and Characteristic Posterior Pole Findings in Exudative Age-related Macular Degeneration Patients. Invest. Ophthalmol. Vis. Sci. 2011;52(14):130.
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To determine the incidence of no light perception (NLP) visual acuity in patients with exudative age-related macular degeneration and to correlate prior administration of anti-vascular endothelial growth factor (anti-VEGF) agents and distinctive examination findings within this group.
A total of 9017 Exudative ARMD cases of patients were seen at Wills Eye Institute from 1998 to March 2, 2009. The number of patients with NLP visual acuity and those who also received anti-VEGF agents during their course was determined from chart review and office records. Other possible causes of NLP visual acuity were considered and ultimately ruled out after performing a repeat examination, in conjunction with a detailed chart review of previous symptoms, time course, fundus photos, fluorescein angiography and optical coherence tomography. The main outcome measure was the number of exudative age-related macular degeneration patients with proven NLP visual acuity. Secondary outcomes included anti-VEGF administration frequency and dilated fundus examination findings.
There were five cases of NLP visual acuity in patients with exudative age-related macular degeneration with an incidence of 0.06%. This population subset included both patients who had received intravitreal injection of anti-VEGF agents and those who did not- three and two, respectively. All five patients possessed a 360-degree fibrous elliptical disciform scar surrounding both the macula and the optic nerve in the horizontal axis that was superior and inferior to the optic disc vertically.
The incidence of exudative macular degeneration patients who progress to NLP visual acuity is exceptionally low, 0.06%. In this small population, progression to NLP visual acuity occurred irrespectively of anti-VEGF agent administration. Finally, all cases possessed a distinct 360-degree fibrous elliptical disciform scar surrounding both the macula and the optic nerve- a newly described and unique posterior pole finding in patients with exudative age-related macular degeneration.
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