Abstract
Purpose :
To investigate the clinical characteristics and outcomes of bilateral neovascular age-related Macular Degeneration (nAMD) in Korean patients.
Methods :
We retrospectively studied 40 patients with bilateral nAMD and 80 matched patients with unilateral nAMD.
Results :
In the first affected 40 eyes, 19 were typical AMD (47.5%), 12 were polypoidal choroidal vasculopathy (PCV) (30.0%) and 9 were retinal angiomatous proliferation (RAP) (22.5%). In the second affected 40 eyes, 18 were typical AMD (45.0%), 12 were PCV (30.0%) and 10 were RAP (25.0%). Overall, 82.5% of patients had the same disease type in each eye (Cohen kappa=.717).
At initial diagnosis, the second affected eyes had visual acuity (VA) of 0.60±0.50 logMAR, better than the first eyes, 0.88±0.52 logMAR (p=.017). Central macular thickness (CMT) were 308.8±85.9 um in the first affected eyes and 295.5±94.9 um in the second eyes, showed no difference (p=.515).
Mean follow-up period was 45.6 months, each eyes received 7.7±6.3 anti-VEGF treatments. 9 eyes underwent 13 photodynamic therapies and 4 eyes underwent 7 surgeries. 4 eyes underwent 6 intravitreal gas injections and only one eye received 2 subtenon triamcinolone injections. There was no difference in the counts of treatments between two groups.
VA was not improved in both groups after follow-up period (p=.149 and .104, respectively). However, CMT was significantly decreased to 229.5±65.0 um in the first affected eyes and 238.4±57.0 um in the second eyes (p=.000 and .001, respectively). There was no significant difference in VA and CMT between two groups after follow-up period (p=.916 and .517, respectively).
In comparison with the first affected eyes, 80-matched unilateral nAMD eyes showed no differences between in CMT at initial diagnosis, follow-up period, counts of treatments, VA and CMT after follow-up period. However, VA in unilateral nAMD patients at the initial diagnosis was better, 0.63±0.45 logMAR (p=.011). There was no difference between the second affected eyes and 80-matched unilateral nAMD eyes in all analysis.
Conclusions :
In bilateral involvement of nAMD, good concordance of disease type between the first and second affected eyes was observed. The first affected eyes showed worse VA at the initial diagnosis. However, treatment outcomes showed no significant difference among the first and the second affected bilateral nAMD eyes and unilateral nAMD eyes.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.