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W. P. Patton, K. A. Muldrew, T. Peto, S. P. Harding, P. Lenfesty, U. Chakravarthy; Lesion Components in Eyes of Patients With Neovascular AMD Without Active CNV: Analysis of a Subset of Angiograms Graded in the VPDT Cohort Study for the UK. Invest. Ophthalmol. Vis. Sci. 2008;49(13):578.
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© ARVO (1962-2015); The Authors (2016-present)
To report on lesion characteristics in angiograms of patients with neovascular AMD where no active CNV was present on standardised grading.
NetwORC UK consists of three separate reading centres linked electronically. Angiograms used in this study were from patients undergoing photodynamic therapy in the UK. Angiograms from some 5000 patients per annum are submitted and categorised as classic, predominantly classic, minimally classic or occult. Features that were assessed and quantified included type and area of CNV, fibrosis, blocked fluorescence due to blood, serous pigment epithelial detachment (SPED) and atrophy (geographic atrophy (GA) and non-GA).
Of the angiograms from 6833 patients that were graded at NetwORC UK between Oct 05 and Oct 07, 7.9% (537/6833) were categorised as having no active CNV. Common lesion features that were present in this group were mainly fibrosis and atrophy. The table below shows the frequency of lesion components and any combinations found to be present. Fibrosis and/or atrophy were the commonest lesion components and together accounted for more than half of all lesions without active CNV. Blood was the sole lesion component in some 6% of lesions and serous PED alone in approximately 6% of lesions.
As expected fibrosis and atrophy occur frequently in end stage lesions. Almost 10% of lesions with either fibrosis or atrophy also had blood indicating continuing CNV activity even though no leakage from active vessels could be identified. It was also notable that some 10% of neovascular AMD lesions without active CNV were seen to contain an SPED. Although blood and fluid are markers for neovascular AMD, their presence does not necessarily mean that the CNV is leaking and active.
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