Purchase this article with an account.
M. R. Munk, C. G. Kiss, F. Sulzbacher, S. Eisenkoelbl, W. Huf, U. Schmidt-Erfurth; Short Term Progression of Neovascular Amd. Invest. Ophthalmol. Vis. Sci. 2010;51(13):4936.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To evaluate the short-term progression of neovascular age-related macular degeneration (AMD).
65 patients suffering from subfoveal CNV secondary to neovascular AMD were examined for inclusio into multicenter trials and observed until treatment initiation (baseline). Time intervals between screening and baseline varied from 2 to 110 days. Best Corrected Visual Acuity (BCVA) using EDTRS-charts, Cirrus HD-OCT and fluorescein angiography (FA) were obtained and changes of BCVA, retinal thickness and lesion size were compared according to lesion type over time.
BCVA: Neither Type I lesions (=classic and predominantly classic CNV), nor Type II lesions (= minimal classic and occult CNV) showed significant deterioration of the BCVA letter score over time.HD-OCT: Differences of average thickness measurements and also of retinal volume in Type I lesions showed a limited, non-signifcant progression: retinal average thickness increased by 4,78±0,94µm and retinal volume increased by 0,11±0,03mm³. There was no measurable progression of HD-OCT parameters in Type II lesions.FA: The mean leakage size at 10 minutes after dye injection differed significantly, both in the pooled sample (Type I and Type II) and also if analysed separately. Considering the pooled sample, there was an increase from 5,50±0,62µm² at screening to 7,60±0,86µm² at baseline (p<0,00001). Type I lesions enlarged from 4,65±0,90µm² to 7,83±1,62µm² (p<0,007), while Type II lesions only progressed from 6,08±0,85µm² at screening to 7,45±0,96µm² at baseline (p<0,00001). The mean increase of leakage size per day in the pooled sample was 0,60±0,02µm², p<0,04. In a separate analysis, Type I showed a daily growth of 0,67±0,08µm² (p<0,02) while Type II lesion growth was markedly slower at 0,06±0,008µm² per day(p<0,000001).
FA seems to be more sensitive to the dynamic of CNV size over time. The progression of Type I lesions is 10 times faster than Type II lesions. Standard HD-OCT parameters offer only limited sensitivity to observe short-term progression in subfoveal CNV. BCVA did not show significant deterioration over the observed time interval, which might be attributed to a learning effect.
This PDF is available to Subscribers Only