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Ga Eun Cho, Se Woong Kang, Song Ee Chung, Sang Jin Kim, Jae Hui Kim, Mingui Kong; Angiographic and Tomographic Characterization of Intermediate Age-related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2014;55(13):3404.
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To characterize the eyes with both choroidal thickening and hyperpermeability in subjects diagnosed with bilateral intermediate age-related macular degeneration (AMD).
We included 102 Korean patients with bilateral intermediate AMD, 15 patients with unilateral exudative AMD, 15 patients with unilateral polypoidal choroidal vasculopathy (PCV), and 15 patients with unilateral active central serous chorioretinopathy (CSC) in this cross-sectional observational study. Intermediate AMD was defined in accordance with Age-Related Eye Disease Study (AREDS) criteria. Eyes of bilateral intermediate AMD were categorized by the presence of choroidal hyperpermeability and the mean subfoveal choroidal thickness (SFCT). Those (group B) with both choroidal hyperpermeability and above-mean SFCT were compared with the rest of eyes (group A), regarding the demographic, tomographic and angiographic variables. In addition, group B was compared with unaffected fellow eyes of unilateral exudative AMD, PCV, and CSC, which manifested subretinal or sub-retinal pigment epithelial deposits (SD), classifiable as AREDS category 3 intermediate AMD (three representative diagnostic groups).
There were 70 eyes (34.3%) of 38 patients with both above-average SFCT and choroidal hyperpermeability (group B). Compared with group A, group B patients tended to be younger (66.3 ± 9.3 years vs. 59.1 ± 7.1 years, p <0.001) and showed male preponderance (35.9 % vs. 71.8 %, p = 0.002). In group B, SDs were larger (p = 0.010) and had relatively non-circular margin (p = 0.003), asymmetric distribution (p = 0.012), pigment abnormality more frequently (p = 0.042) on funduscopy. Eyes in group B were also more frequently accompanied by pathologic tomographic findings (p = 0.012) and choroidal filling delay (p = 0.001), compared with those of group A. There was marked similarities in the characteristics of SD, choroidal thickness profile, and demography between group B and the fellow eyes of unilateral CSC.
These results suggest that about a third of eyes diagnosed as intermediate AMD by funduscopy may constitute different disease characteristics from the majority of such cases in the Asian population. The tomographic and angiographic features suggest these lesions to possibly be a form of chronic inactive CSC.
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