June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
The Incidence of Neovascular Subtypes in Newly Diagnosed Wet Age-Related Macular Degeneration
Author Affiliations & Notes
  • Jesse Jung
    Department of Ophthalmology, New York Univ School of Med, New York, NY
    LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear, and Throat Hospital, New York, NY
  • Luna Xu
    Vitreous Retina Macula Consultants of New York, New York, NY
    St. Vincent's Medical Center, Bridgeport, CT
  • Roberto Gallego-Pinazo
    Vitreous Retina Macula Consultants of New York, New York, NY
    Department of Ophthalmology, University and Polytechnic Hospital La Fe, Valencia, Spain
  • Sarah Mrejen
    Vitreous Retina Macula Consultants of New York, New York, NY
    LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear, and Throat Hospital, New York, NY
  • Marcela Marsiglia
    Vitreous Retina Macula Consultants of New York, New York, NY
    LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear, and Throat Hospital, New York, NY
  • Sucharita Boddu
    Department of Ophthalmology, New York Univ School of Med, New York, NY
  • K Bailey Freund
    Department of Ophthalmology, New York Univ School of Med, New York, NY
    Vitreous Retina Macula Consultants of New York, New York, NY
  • Footnotes
    Commercial Relationships Jesse Jung, None; Luna Xu, None; Roberto Gallego-Pinazo, Bayer (R), Novartis (R), Novartis (C), Carl Zeiss Meditec (R); Sarah Mrejen, None; Marcela Marsiglia, None; Sucharita Boddu, None; K Bailey Freund, Genentech (C), Regeneron (C), ThromboGenics (C), Bayer (C), DigiSight (C)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 4095. doi:https://doi.org/
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      Jesse Jung, Luna Xu, Roberto Gallego-Pinazo, Sarah Mrejen, Marcela Marsiglia, Sucharita Boddu, K Bailey Freund; The Incidence of Neovascular Subtypes in Newly Diagnosed Wet Age-Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4095. doi: https://doi.org/.

      Download citation file:


      © ARVO (1962-2015); The Authors (2016-present)

      ×
  • Supplements
Abstract
 
Purpose
 

To determine the frequencies of neovascular lesion subtypes in newly diagnosed neovascular age-related macular degeneration (AMD) and to determine whether these frequencies differ when grading is based on fluorescein angiography (FA) or both FA and optical coherence tomography (OCT).

 
Methods
 

We retrospectively analyzed a consecutive series of patients treated by a single physician with intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy for the diagnosis of neovascular AMD from January 2006 through January 2012 in order to identify newly diagnosed treatment-naïve cases. Inclusion criteria included: age over 50 years; best corrected visual acuity of 20/40 to 20/800, new onset of treatment-naïve CNV, and absence of permanent structural damage to the central fovea. Two independent graders classified the lesions based on FA [poorly defined (occult), well-defined (classic), or retinal angiomatous proliferation (RAP)] and with both FA and OCT [type 1 (sub-RPE), 2 (subretinal) or type 3 (intraretinal) neovascularization]; a third grader evaluated the lesion in the presence of significant discrepancies. Analysis between agreement in lesion subtype by FA alone or FA/OCT was performed using Chi-squared for two categorical variables. For each subtype of CNV, the association between demographic factors was also assessed. Analysis was performed using Stata 11 software (StataCorp, College Station, TX).

 
Results
 

Among 748 AMD patients treated with anti-VEGF therapy, a total of 531 eyes were treatment-naive and 311 fit the inclusion criteria. The average age at first injection was 81.5 years. 68.5% were women and 31.5% men. 95.5% were Caucasian, 2.9% Hispanic, and 1.9% Asian or Black. Based on FA classification alone, 47.9% had occult, 9.5% classic, 35.1% RAP, and 7.4% had mixed CNV lesions. In comparison, using FA/OCT, we found 43.4% type 1, 8.8% type 2, 36.4% type 3 (RAP), and 11.4% mixed. Subset analysis of the demographic variables and frequency for each CNV type demonstrated no significant differences.

 
Conclusions
 

With both forms of grading, we found a much higher incidence of type 3 (RAP) lesions and lower incidence of type 2 (classic) lesions than found in prior studies. Combined FA/OCT grading identifies a higher frequency of mixed CNV lesions as the addition of OCT appears useful in clarifying the location of the neovascular tissue in relation to the RPE.

 
Keywords: 412 age-related macular degeneration • 453 choroid: neovascularization • 550 imaging/image analysis: clinical  
×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×