April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
Origin and behavior of Type 3 neovascularization revealed by spectral-domain optical coherence tomography
Author Affiliations & Notes
  • Aaron Nagiel
    UCLA, Los Angeles, CA
  • K Bailey Freund
    Vitreous-Retina-Macula Consultants of New York, New York, NY
  • Jesse J Jung
    Vitreous-Retina-Macula Consultants of New York, New York, NY
  • Kavita Bhavsar
    Vitreous-Retina-Macula Consultants of New York, New York, NY
  • Richard F Spaide
    Vitreous-Retina-Macula Consultants of New York, New York, NY
  • David Sarraf
    UCLA, Los Angeles, CA
    Kaiser Permanente, Woodland Hills, CA
  • Footnotes
    Commercial Relationships Aaron Nagiel, None; K Bailey Freund, None; Jesse Jung, None; Kavita Bhavsar, None; Richard Spaide, None; David Sarraf, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 3938. doi:https://doi.org/
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      Aaron Nagiel, K Bailey Freund, Jesse J Jung, Kavita Bhavsar, Richard F Spaide, David Sarraf; Origin and behavior of Type 3 neovascularization revealed by spectral-domain optical coherence tomography. Invest. Ophthalmol. Vis. Sci. 2014;55(13):3938. doi: https://doi.org/.

      Download citation file:


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

      ×
  • Supplements
Abstract
 
Purpose
 

To demonstrate the origin, maturation, and treatment response of Type 3 neovascularization in eyes with age-related macular degeneration (AMD) using high-resolution spectral-domain optical coherence tomography (OCT).

 
Methods
 

We retrospectively analyzed 21 eyes with Type 3 neovascularization and AMD for which spectral-domain OCT images were obtained over multiple clinic visits. Images were evaluated for site of origin, associated retinal pigment epithelium detachment (PED), intraretinal edema, sub-retinal pigment epithelium (RPE) fluid, reticular pseudodrusen, and progression to geographic atrophy.

 
Results
 

18/21 (86%) Type 3 lesions were associated with an underlying PED, of which 16 (89%) were drusenoid and 2 (11%) were serous. In 7 eyes, serial OCT imaging captured the development of Type 3 neovascularization from an early precursor lesion that appeared to originate above the external limiting membrane (ELM) without evidence of underlying Type 1 or 2 choroidal neovascularization. In every case, the mature Type 3 lesions were associated with outer retinal and RPE disruption as well as adjacent cystoid edema of the retina. In 7/21 (33%) eyes, the vascular complex was associated with sub-RPE fluid. Treatment with intravitreal anti-vascular endothelial growth factor (VEGF) agents resulted in complete resolution of the intraretinal and sub-RPE fluid as well as involution of the lesion in every case. Following treatment, most cases (57%) progressed to geographic atrophy (GA) at the former site of the Type 3 vessels.

 
Conclusions
 

Type 3 neovascularization in AMD appears to originate above the ELM from the deep retinal capillary plexus and matures into a larger vascular complex that usually forms over a drusenoid PED. The mature vascular plexus appears to exude fluid into the retina and beneath the RPE through a focal RPE defect. Regression of these lesions following treatment with intravitreal anti-VEGF therapy is often associated with the development of GA.

 
Keywords: 412 age-related macular degeneration • 688 retina • 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.

×