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Giuseppe Querques, Mayer Srour, Nathalie Massamba, Anouk Georges, Naima Ben Moussa, Omer Rafaeli, Eric H. Souied; Functional Characterization and Multimodal Imaging of Treatment-Naïve “Quiescent” Choroidal Neovascularization. Invest. Ophthalmol. Vis. Sci. 2013;54(10):6886-6892. doi: https://doi.org/10.1167/iovs.13-11665.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the multimodal morphological and functional characteristics of treatment-naïve “quiescent” choroidal neovascularization (CNV) secondary to AMD.
Eleven patients with treatment-naïve “quiescent” CNV that consecutively presented over a 6-month period, underwent multimodal morphological and functional assessment (including indocyanine green angiography [ICGA], spectral-domain optical coherence tomography [SD-OCT], microperimetry, and preferential hyperacuity perimeter [PHP]). For the purpose of this study, asymptomatic previously untreated CNVs showing absence of intraretinal/subretinal exudation in two consecutive visits (at least 6 months apart) were defined as treatment-naïve “quiescent” CNV.
Eleven eyes of 11 patients (9 females; mean age 76.5 ± 8.5 years) were included. On fluorescein angiography (FA), “quiescent” CNVs appeared as late speckled hyperfluorescent lesions lacking well-demarcated borders. Mid-late phase ICGA allowed visualizing the hyperfluorescent “quiescent” CNV network and delineating the plaque. Mean lesion area (mid-late phase ICGA) appeared larger compared with earliest previous examination performed 23.8 ± 16.0 months before (3.24 ± 2.51 mm2 vs. 3.52 ± 2.46 mm2, respectively; P = 0.01). SD-OCT revealed, at the site of “quiescent” CNV, an irregularly slightly elevated RPE, without hyporeflective intraretinal/subretinal fluid, showing a major axis in the horizontal plane, which was characterized by collections of moderately reflective material in the sub-RPE space and clear visualization of the hyperreflective Bruch's membrane. Hypergeometric distribution revealed a significant correlation between microperimetry and PHP with respect to locations of “affected areas” (P = 0.001).
“Quiescent” CNVs are sub-RPE CNVs secondary to AMD, showing absence of intraretinal/subretinal exudation on repeated OCT. “Quiescent” CNVs enlarge over time and may contribute to local reduced retinal sensitivity and metamorphopsia.
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