Neovascular age-related macular degeneration without drusen in the fellow eye: clinical spectrum and therapeutic outcome.

Abstract

PURPOSE:

To investigate the clinical characteristics and therapeutic outcome of patients with neovascular age-related macular degeneration (nAMD) in 1 eye, without drusen in the fellow eye.

PATIENTS AND METHODS:

Medical records of 381 patients were analyzed to identify the cases. The main outcomes included Early Treatment Diabetic Retinopathy Study (ETDRS) best-corrected visual acuity (BCVA) and change in central retinal thickness (CRT). These parameters were reviewed at baseline, first follow-up visit, and after 6, 12, and 24 months.

RESULTS:

Out of 381 patients, 29 cases (8%) were included (of whom 3 had polypoidal choroidal vasculopathy [PCV]) who were treated with anti-vascular endothelial growth factor (anti-VEGF) therapy which was supplemented by photodynamic therapy (PDT) in the PCV patients. Overall, no statistically significant change in mean BCVA was observed during follow-up. BCVA improved or remained stable (defined as a gain in BCVA, a stable BCVA, or a loss of <5 ETDRS letters) in 22 patients (76%), and 7 patients (23%) had lost ≥5 ETDRS letters at final follow-up. A gain of ≥15 ETDRS letters at final follow-up was seen in 5 patients (17%). Mean CRT had decreased significantly with 99 µm (P<0.001) at 24 months after the initial visit.

CONCLUSION:

There is a clinical spectrum of nAMD that is not associated with drusen in the fellow eye. Patients with nAMD without drusen in the fellow eye respond to anti-VEGF treatment and, in cases of PCV, to supplemental PDT. The pathophysiology of this spectrum of nAMD may be different from drusen-associated age-related macular degeneration.

• Authors: Wing H Chung, Elon H C van Dijk, Danial Mohabati, Greet Dijkman, Suzanne Yzer, Eiko K de Jong, Sascha Fauser, Reinier O Schlingemann, Carel B Hoyng, Camiel J F Boon
• Journal: Clinical ophthalmology (Auckland, N.Z.) (Clin Ophthalmol) Vol. 11 Pg. 63-70 ( 2017) ISSN: 1177-5467 [Print] New Zealand
• PMID: 28053502 (Publication Type: Journal Article)