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Jose David Morales, Lihteh Wu; Neovascular Subtypes in Treatment Naive Exudative Age-Related Macular Degeneration in Costa Rica. Invest. Ophthalmol. Vis. Sci. 2017;58(8):54.
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© ARVO (1962-2015); The Authors (2016-present)
The current mainstay of treatment of exudative age-related macular degeneration (AMD) is anti-VEGF therapy. Recent reports suggest that certain subtypes of neovascularization may be more responsive than others to anti-VEGF therapy. The purpose of the current study is to report the frequency of neovascularization subtypes using multimodality imaging, including indocyanine green angiography (ICG-A), spectral domain optical coherence tomography (SD-OCT) and fluorescein angiography (FA), in a Costa Rican cohort of patients diagnosed with exudative AMD that were treatment naive.
The charts and macular images of 135 consecutive patients (162 eyes) that were diagnosed with treatment naive exudative AMD during May 2010 and May 2016 were retrospectively reviewed. All patients underwent imaging with infrared reflectance and SD-OCT (Spectralis, Heidelberg Engineering). FA and/or ICG-A were obtained in selected cases. Multimodality images of each eye were analyzed and choroidal neovascularization (CNV) was classified according to the anatomic classification: type 1 CNV (sub-RPE), type 2 (subretinal) and type 3 (intraretinal). Polypoidal choroidal vasculopathy (PCV) was considered to be a subtype of type 1 CNV.
There were 81 (60%) female patients. The mean age was 77 ± 9 years old. At presentation, the mean baseline visual acuity was 0.95 logMAR. At baseline, 5 (3%) eyes had an epiretinal membrane, 4 (2.5%) eyes had vitreomacular traction syndrome, 90 (55.6%) eyes had a pigment epithelial detachment (PED) and 25 (15.4%) eyes had macular atrophy. A total of 128 eyes (79%) had type 1 neovacularization (subretinal pigment epithelium), 9 eyes (5.6%) type 2 (subretinal), 25 eyes (15.4%) type 3 (intraretinal). In addition 35 eyes (21.6%) had polypoidal choroidal vasculopathy (PCV). All the images were reviewed by the 2 authors and discrepancies were adjudicated by the senior author.
The majority of eyes with exudative AMD in Costa Rica exhibit type 1 CNV. A considerable percentage of patients also exhibited PCV.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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