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Christina Ryu, Sulaiman Alhumaid, Aaron Rosen, John Galic, John Chen, Dima Kalache; Correlation of visual acuity with subretinal versus subretinal pigment epithelium location of subfoveal fibrovascular scars in wet age-related macular degeneration. Invest. Ophthalmol. Vis. Sci. 2014;55(13):3405.
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To determine whether a correlation exists between visual acuity (VA) and the location of the subfoveal fibrovascular disciform scar, subretinal versus subretinal pigment epithelium (RPE), in eyes with quiescent wet age-related macular degeneration (AMD).
The SD-OCT studies of 26 eyes of 25 patients with a clinically apparent subfoveal fibrovascular scar and no active leakage after anti-VEGF therapy for wet AMD were reviewed retrospectively. The location of the subfoveal scars was characterized as sub-RPE, subretinal, both, or indeterminate. Additional SD-OCT characteristics were analyzed including the presence of clefts within the fibrovascular scar, disruption of the inner segment/outer segment junction, and disruption of the external limiting membrane.
Of the 26 eyes with clinically apparent subfoveal fibrovascular scar, preliminary results show that 46% of the scars were characterized as sub-RPE and 54% were characterized as having some subretinal component - subretinal, both subretinal and sub-RPE, or indeterminate. In the eyes with sub-RPE scar, 25% had final VA worse than 20/200, compared to 57% in the eyes with a subretinal component to the scar (p = 0.132). The eyes with sub-RPE scars were less likely to have disruption of the inner segment-outer segment junction and external limiting membrane as compared to the scars with a subretinal component. This study also investigates the possible correlation between visual acuity and the presence of clefts within the fibrovascular scar, which may represent vascularization of the scar. Results thus far show that approximately equal number of the sub-RPE scars and subretinal component scars are associated with a cleft within the scar.
The presence of a subfoveal fibrovascular disciform scar in wet-AMD often correlates with poor vision, but a sub-RPE location of the scar may portend a better visual prognosis. This may be due to the relative preservation of outer retinal structures.
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