Abstract
Purpose: :
Occult choroidal new vessels (CNV) represent – with classic new vessels – one of the two complications of exudative AMD. Both types are often associated resulting in a challenging classification. Our purpose was to evaluate the proportion of occult CNV and the proportion of pigment epithelium detachment (PED) among exudative AMD in French population.
Methods: :
A total of 300 patients were submitted to a complete examination including best–corrected ETDRS visual acuity, fundus color photography, fluorescein angiography (FA), infra–red angiography with indocyanin green (ICGA) and optical coherence tomography (OCT). Different treatments have been administred according to different diagnosis and therapeutic indications. Classification between classic versus occult CNVs was performed by AZ and EHS.
Results: :
Among the 300 patients, 63 % were female mean age was (55–85). There were as many left eyes affected as right eyes (51 %), 19 % of eyes were pseudophakic. Absence of drusen has been observed in 29 % cases. 13 % of CNVs cases were pure classic on FA. Occult CNVs have been found in 87 % of cases. PED has been visualized by FA in 28 % of eyes whereas 62 % were obvious in OCT. Atrophic lesions were associated to exudative forms in 38 % of cases. Associated hemorrhages and exudates have been found in respectively 41 % and 21 % of eyes.
Conclusions: :
Occult new vessels represented a significant majority of exudative AMD at presentation (87 %). PED associated with occult CNVs is unexpectedly often. Also; PED is better visualized on OCT versus FA. OCT appears to provide a good visualization of the lesion’s activity (presence and amount of fluid, external or internal cystoid macular edema, serous retinal detachment or PED). OCT can help to select, adjust, and guide treatment in exudative AMD.
Keywords: age-related macular degeneration • choroid: neovascularization