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Y. Nomura, A. Iriyama, R. Obata, Y. Inoue, Y. Tamaki, Y. Yanagi; Vitreomacular Interface and Disease Activity in Typical Age-Related Macular Degeneration and Polypoidal Choroidal Vasculopathy. Invest. Ophthalmol. Vis. Sci. 2009;50(13):740.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the association between the status of vitreomacular interface and disease activity in the two most predominant subtypes of exudative age-related macular degeneration (AMD) in Japanese patients, i.e., typical AMD and polypoidal choroidal vasculopathy (PCV).
This is a retrospective, observational case series. Consecutive patients with the definite diagnosis of typical AMD (n=40) and PCV (n=39) who received photodynamic therapy (PDT) were included in this study. B-mode ultrasonography was performed to investigate the presence of posterior vitreous detachment (PVD). Vitreomacular attachment was also examined using optical coherence tomography (Stratus OCT, Carl-Zeiss, Thornwood) in horizontal and vertical scans covering a 5 mm area including the center of the fovea. The eyes were considered to have vitreomacular separation (VMS) when B-mode ultrasonography detected PVD and OCT did not detect vitreomacular attachment. Firstly, the lesion size, as expressed by greatest linear dimension (GLD), was determined and the correlation of VMS and GLD were examined. Secondly, using the number of PDT sessions required to stabilize the lesion as a surrogate marker, the impact of VMS on the treatment efficacy was investigated. Students’ t-tests were used for statistical analysis.
In typical AMD, 21 (52.5%) of 40 eyes were without VMS. GLD was significantly larger when VMS was not present (3440µm vs 5020µm, in the presence and absence of VMS, respectively P=0.007), whereas in PCV, 17 (43.6%) of 39 eyes were without VMS and the presence or absence of VMS was not related with the lesion size (3535µm vs 4460µm, in the presence and absence of VMS, respectively, P=0.082). Both in typical AMD and PCV, the number of PDT sessions required to stabilize the lesion was not different with or without the presence of VMS.
There is an association between the status of vitreomacular interface and the lesion size in typical AMD but not PCV. The status of vitreomacular interface does not have a major impact on the treatment efficacy of PDT in both typical AMD and PCV.
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