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S. Mukerjee, A. Tewari, O. Plous, J.E. Puklin; Angiographic Patterns and Locations of Choroidal Neovascularization (CNV) in Patients With Exudative Age–Related Macular Degeneration (ARMD): A Retrospective Review of Fluorescein Angiograms at the Kresge Eye Insitute Over a Three–Year Period . Invest. Ophthalmol. Vis. Sci. 2005;46(13):228.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: The purpose of this study is to identify new, untreated CNV's in patients with ARMD presenting to a large urban eye center and to determine the type and location of these CNV's as defined by the Macular Photocoagulation Study (MPS) and the Treatment of Age–Related Macular Degeneration with Photodynamic Therapy (TAP) Study Group. Methods: Fluorescein angiographic patterns of exudative ARMD were categorized by two schemes: the MPS and the TAP. CNV's were categorized by location (subfoveal, juxtafoveal, extrafoveal), type (occult or classic), and subtype (classic: purely, predominantly, minimally; occult: fibrovascular pigment epithelial detachment (PED), late phase leakage of undetermined source). The archived angiogram database was reviewed from December 2001 to October 2004 for all patients with a presumptive diagnosis of ARMD. The first fluorescein angiogram of each eye was selected for analysis. Seven–hundred and forty patients were initially identified in the database with ARMD. Patients' eyes were excluded if the angiogram demonstrated non–exudative ARMD, poor quality photography, or scarred or previously treated lesions. One–hundred and thirty–four eyes met the criteria of new choroidal neovascular membranes associated with ARMD. Results: According to the MPS classification, 67/134 (50.0%) of the lesions were subfoveal, 41/134 (30.6%) were juxtafoveal, and 26/134 (19.4%) were extrafoveal, 104/134 (77.61%) of membranes being classic and 30/134 (22.39%) being occult. Of the occult lesions, 20/134 (14.93%) were fibrovascular PEDs and 10/134 (7.46%) were late phase leakage of undetermined source. As defined by the TAP classification, the classic CNV subtypes were distributed as follows: 84/134 (62.69%) purely classic, 11/134 (8.21%) predominantly classic, and 9/134 (6.72%) minimally classic. Conclusions: The classic type of CNV is the principal type of membrane in exudative ARMD, of which the most prevalent subtype is purely classic followed in frequency by the predominantly and minimally classic subtypes. Two–thirds of the occult lesions were fibrovascular PEDs, with one–third being the late phase leakage of undetermined source subtype. CNVs tend to be focused on the fovea, as the primary lesion location is subfoveal, followed in prevalence by juxtafoveal and extrafoveal lesions.
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