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Melissa D. Neuwelt, Tushar M. Ranchod, Lawrence Y. Ho, Lisa J. Faia, Caesar K. Luo, George A. Williams; Schitic Macular Atrophy in Neovascular Age-related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2011;52(14):163.
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To describe and characterize an end-stage retinal morphology, schitic macular atrophy (SMA), detected by optical coherence tomography in eyes with neovascular age-related macular degeneration (AMD).
A retrospective review was undertaken of patients diagnosed with SMA due to neovascular AMD documented using spectral-domain OCT (Cirrus HD-OCT, Carl Zeiss Meditec, Dublin, CA) or time-domain OCT (Status OCT, Carl Zeiss Meditec) between January 1, 2009 and May 1, 2010.
Eleven eyes were diagnosed with SMA. Subjects included three males and eight females with an average age of 79 years at first presentation with choroidal neovascularization (CNV) and an average of six years between presentation with CNV and development of SMA. SMA was identified in one eye of each patient, and the fellow eye developed CNV in all patients except two. One patient received anti-VEGF treatment following the identification of SMA, with no improvement in vision.
We describe a series of patients with neovascular AMD in whom chronic cystoid macular edema (CME) coalesced into a schisis cavity, termed schitic macular atrophy (SMA). The progression of CME to SMA suggests that the loss of bridging tissue in the outer retina may cause irreversible damage and may represent a reasonable endpoint for cessation of therapy for neovascular AMD.
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