Purchase this article with an account.
S Wolf, A Nestler, DC Trost, MB Reichel; Natural History of Occult Choroidal Neovascularization in Age-Related Macular Degenderation: Conversion From Occult to Classic Lesions . Invest. Ophthalmol. Vis. Sci. 2002;43(13):2523.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Purpose: Treatment of exudative age related macular degeneration (ARMD) is limited to classic or predominantly classic choroidal neovascularization (CNV). However, the majority of patients with exudative ARMD have occult CNV. In the natural history some patients with occult CNV may develop classic CNV. To identify these patients a prospective study in patients with occult CNV was undertaken. Methods: In a prospective study we included patients with occult CNV secondary to ARMD. Inclusion criteria were visual acuity of 20/80 or better, presence of exudative ARMD with an occult CNV and no other ocular disease. Examinations included visual acuity, binocular ophthalmoscopy, fluorescein and ICG angiography with a scanning laser ophthalmoscope (HRA, Heidelberg Eye Explorer, Heidelberg Engineering GmbH, Germany). and color fundus photography. All examinations were performed at baseline, 6 weeks, 3, 6, and 12 months thereafter. At each follow-up examination the lesion was classified as occult, predominately occult (< 50% classic), predominately classic (≷50% classic), or classic CNV. Results: Sixty patients (32 female, 28 male) were included into the study. Age ranged from 52-88 years (mean: 71 8,1 years). Visual acuity ranged from 20/80 to 20/20 at baseline. At baseline 53 patient had occult CNV and 7 a predominately occult lesion. During follow-up 8 patients developed a predominately classic CNV and 13 patients with initially purely occult CNV developed a classic component. All patients developing predominantly classic lesions had experienced visual loss (≥3 ETDRS lines). Conclusion: This prospective study indicates that in patients with ARMD development of a predominately classic CNV from a purely occult CNV occurs in ab13% of patients within 12 months. Since the development of predominately classic CNV was associated with visual loss in all cases, we recommend angiographic re-evaluation in all patients with occult CNV that experience a visual loss.
This PDF is available to Subscribers Only