Characteristics of Exudation in Patients with Bilateral Large Drusen

Abstract

Abstract: : Purpose:To describe the characteristics of newly diagnosed choroidal neovascularization (CNV) and serous detachment of the pigment epithelium (S–PED) in untreated eyes of patients with bilateral large drusen. Methods:The fluorescein angiograms (FAs) of 1052 patients participating in the Complications of AMD Prevention Trial (CAPT) were graded for the presence of CNV or S–PED. At baseline, eligible patients had >10 large (>125 µ) drusen in each eye. FAs are performed at baseline, annual visits, and whenever the CAPT ophthalmologist suspects that CNV has developed. Lesion composition (classic and/or occult), size (MPS Disc Areas), and location (subfoveal or not) were recorded for CNV developing in untreated eyes. Visual acuity was measured by certified examiners following a standard protocol. Results:Among the first 67 untreated eyes identified with exudation, 90% had CNV only, 9% had a combination of CNV and S–PED, and 1% had S–PED only. Among CNV lesions, 70% were occult only, 18% were classic and occult, and 7% were classic only. Approximately half (52%) were < 2 Disc Areas and all were < 9 Disc Areas. 57% of lesions were subfoveal. Visual acuity was 20/40 or better in 66% of the eyes at the first regularly scheduled visit with exudation. 56% of the subfoveal lesions and 80% of the non–subfoveal lesion had vision 20/40 or better. Conclusions:The characteristics of CNV, in this closely monitored group of patients with bilateral large drusen, differs from the characteristics of CNV provided in published reports of case series from referral centers.

Keywords: age–related macular degeneration • drusen • clinical (human) or epidemiologic studies: natural history