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C.M. Eandi, R. Iranmanesh, S. Garuti, E. Peiretti, C.M. Klais, D.E. Goldberg, L.A. Yannuzzi; The Nature and Frequency of Neovascular Age Related Macular Degeneration . Invest. Ophthalmol. Vis. Sci. 2005;46(13):3311.
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Purpose: This study was designed to evaluate the frequency and nature of neovascular pattern in AMD utilizing the combination of digital imaging techniques, fluorescein angiography (FA), indocyanine green angiography (ICG), and optical coherence tomography (OCT). A secondary objective was to determine the value of these diagnostic adjuncts in studying these patients. Methods: A complete clinical examination was performed on consecutive newly diagnosed patients with neovascular AMD. Digital fluorescein and indocyanine green (ICG) angiography, and optical coherence tomography (OCT) were also used in the vast majority of the patients. Lesion characteristics were assessed and the total lesion size and greatest linear dimension (GLD) were measured by digital imaging techniques. We compared the imaging techniques to determine their value. Results: A total of 100 eyes of 93 patients with neovascular AMD were recruited for the study. There were 32 men and 68 women. The mean age was 79 years (range 61 to 95 years). 16 eyes were diagnosed as classic CNV, 15 as minimally classic CNV, and 69 as occult CNV. Of the 84 eyes with either minimally classic CNV or occult CNV, 14 were found to have polypoidal CNV (16.7%), and 16 had retinal angiomatous proliferation (RAP) (19.0%). In this study FA showed that 16% of the patients presented classic CNV, 15% minimally classic, and 69 occult CNV. ICG was superior for detecting occult CNV, polypoidal CNV, and RAP. OCT determined the presence of cystoid macular degeneration in the vast majority of the eyes with RAP. Conclusions: Our results suggest that FA, ICG, and OCT, when used in combination, will allow the clinician to best clarify the precise nature of the neovascular process in AMD. Knowledge of the exact nature of the neovascularization could help to establish a better prognosis, a clearer understanding of the natural history, and an improved response to specific forms of treatment.
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