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Riccardo Sacconi, Maria Brambati, Alexandra Miere, Eliana Costanzo, Vittorio Capuano, Enrico Borrelli, Marco Battista, Maria Cristina Parravano, Eric H Souied, Francesco Bandello, Giuseppe Querques; Characterization of macular neovascularization in geographic atrophy. Invest. Ophthalmol. Vis. Sci. 2021;62(8):237.
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© ARVO (1962-2015); The Authors (2016-present)
To characterize macular neovascularization (MNV) developing in eyes affected by geographic atrophy (GA).
In this multicentric longitudinal study, patients previously affected by GA that developed an active MNV were included in 3 retina referral centers. Patients were investigated using structural optical coherence tomography (OCT), fundus autofluorescence, OCT-angiography, and dye angiographies. Patients were treated with ProReNata (PRN) anti-vascular endothelial growth factor (VEGF) injections and were revaluated after treatment.
Among 512 patients previously diagnosed with GA, 40 eyes of 40 patients (mean age 80.8±7.9 years, mean GA area 8.73±7.39 mm2) presented with treatment-naïve exudative MNV (accounting for an estimated prevalence of 7.81%; 5.49 - 10.13, 95% confidence intervals) and thus were included in the analysis. 67.5% of MNVs were classified as type 2 MNV, 25% as type 1, 2.5% as type 3, and 5% as mixed phenotype. In 92.5% of cases, active MNV in GA showed subretinal hyperreflective material (SHRM) with or without evidence of sub-/intra-retinal hyporeflective exudation. During a mean follow-up of 28±25 months, patients were treated with 6.6±6.3 anti-VEGF injections, with 2.9±1.4 injections in the first year of treatment. No patient developed GA enlargement in the area of MNV.
MNVs in GA showed different multimodal imaging features and therapeutic response in comparison to previously reported features of MNV in age-related macular degeneration (AMD) without GA. For these reasons, the combined phenotype (i.e. GA with neovascular AMD) should be considered as a distinct entity in the research and clinical setting.
This is a 2021 ARVO Annual Meeting abstract.
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