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S. Waldstein, U. Sponer, C. Simader, S. Sacu, U. Schmidt-Erfurth; The Influence of Vitreomacular Interaction on the Development of Exudative Age-Related Macular Degeneration: 4-Year-Results of a Longitudinal Study. Invest. Ophthalmol. Vis. Sci. 2010;51(13):95.
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To investigate the influence of vitreomacular interaction on the development of exudative changes in high-risk eyes with non-exudative age-related macular degeneration (AMD).
53 patients with AREDS grade IV AMD were included into this prospective study. Follow-up examinations, including ETDRS best-corrected visual acuity, optical coherence tomography (OCT) and flourescein angiography (FA), were performed every 3 months for a period of 4 years. Vitreomacular interaction was assessed with time- and spectral-domain OCT (Stratus® OCT and Cirrus® OCT including its prototype, respectively). Development of choroidal neovascularization (CNV) was evaluated clinically based on OCT- and FA-results.Patients were divided into two groups according to vitreomacular interface configuration with regards to vitreomacular interaction. Occurence of exudative changes in eyes with previously non-exudative AMD was defined as primary endpoint and compared with respect to presence or absence of vitreomacular interaction.
49 eyes of 53 patients were included into analysis, while 4 patients were excluded due to study drop-out within the first year. 37% of patients (18 of 49) developed exudative changes during the observation period. Vitreomacular interaction was present in 20% (10 of 49) and absent in 80% (39 of 49) of study eyes, respectively.In the group with vitreomacular interaction, development of CNV occurred in 40% of subjects (4 of 10). The average time from baseline to disease progression was 17±15 months.In the group without vitreomacular interaction, 36% of patients developed CNV (14 of 39). Mean time from baseline to disease progression was 23±12 months.There was no significant difference between the two groups concerning proportions with CNV development or time to disease progression (p=0.94, log-rank survival analysis).
No significant influence of vitreomacular interaction on the development of exudative age-related macular degeneration could be found in long-running observation of a homogenous population. Hence, there is no evidence that hyaloid should play a major role in the patho-physiologic mechanisms leading to choriodal neovascularization in AREDS grade IV patients.
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