Purpose:
To assess the clinical features and response to therapy of angiographically defined PRPE- CNV in patients presenting the accepted characteristics of ARMD
Methods:
In this still on-going retrospective study, all second eyes presenting with PRPE-CNV were included if the patient was more than 60 years of age. A complete ophthalmologic examination had to be available, including pre-injection frames, fluorescein angiography, ICG angiography and SD-OCT in order to identify all types of drusen and to exclude occult sub-epithelial CNV. A 6 and 12 month post anti-VEGF treatment examination allowed evaluation of response to treatment.
Results:
The analysis of the first 100 eyes showed that initially PRPE-CNV were accompanied by hard drusen in 19 eyes but no high risk lesions neither on fluorescein nor on ICG angiography could be ascertained. The response to anti-VEGF injections was in all cases rapid (after 2 to 4 injections) and resulted in quiescent CNV on the angiographic examinations and a complete resorbtion of intra-retinal fluid on OCT.
Conclusions:
This study raises a doubt on the belonging of PRPE-CNV to ARMD as these rare clinical form present specific features and responds unusually favourably to anti-VEGF treatment. In addition, a precise genetic background (ARSM2-HTRA1) has been previously identified. These different characteristics suggest that classic PRPE-CNV is a group apart from ARMD, possibly idiopathic CNV in elderly patients.
Keywords: imaging/image analysis: clinical • choroid: neovascularization • clinical (human) or epidemiologic studies: natural history