Decreased Visual Acuity Associated With Cystoid Macular Edema in Neovascular Age-related Macular Degeneration

Ting, T. D.; Oh, Mila; Cox, Terry A.; Meyer, Carsten H.; Toth, Cynthia A.

doi:10.1001/archopht.120.6.731

Cited by 96 publications

(50 citation statements)

References 20 publications

(19 reference statements)

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“…No information was given on the visual acuity of the patients presenting with this fluorescein angiographic finding. In a recent study, 14 cystoid macular edema was demonstrated on optical coherence tomography imaging in 46% of 61 eyes with subfoveal choroidal neovascularization associated with age-related macular degeneration, more commonly in choroidal neovascularization containing classic component. The presence of cystoid macular edema and increased foveal thickness correlated with decreased visual acuity, as was noted in our study.…”

Section: Our Findings Show That Pdt Is Well Tolerated In Amentioning

confidence: 96%

“…The authors suggested that the retinal thickening (macular edema) may be a contributing factor to the decreased visual acuity in patients with age-related macular degeneration. 14 Cystoid macular edema has been described as one of the angiographic features of retinochoroidal anastomoses in the setting of neovascular age-related macular degeneration. In our series, 6 of the 12 eyes with cystoid macular edema that lost more than 3 lines of Snellen acuity also had retinochoroidal anastomoses on indocyanine green angiography.…”

Section: Our Findings Show That Pdt Is Well Tolerated In Amentioning

confidence: 99%

See 1 more Smart Citation

Photodynamic therapy for age-related macular degeneration in a clinical setting: visual results and angiographic patterns

Axer‐Siegel

Ehrlich

Yassur

et al. 2004

American Journal of Ophthalmology

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• PURPOSE: To evaluate the visual outcome of patients with subfoveal choroidal neovascularization due to agerelated macular degeneration, who received photodynamic therapy (PTD) in a clinical setting and to identify potential predictive visual and angiographic factors.• DESIGN: Interventional case series.• METHODS: The study included 74 patients with subfoveal choroidal neovascularization who underwent PDT from January 2000 to March 2001 and completed at least 1 year follow-up. All patients received verteporfin PDT and were followed clinically, with fluorescein angiography (74 eyes), and with indocyanine green angiography (65 eyes). A review of the medical records and angiograms was performed.• RESULTS: Mean follow-up was 15.6 months. Patients received a mean of 3.4 treatments per year. Sixty-six percent lost less than 3 Snellen lines of visual acuity. Three patients (4%) experienced profound visual acuity loss to finger counting. Final visual acuity was positively correlated with lesion size and visual acuity at presentation. Visual outcome was worse in the presence of cystoid macular edema. On indocyanine green angiography, a round hypofluorescent spot was seen at the site of the PDT, with maintenance of medium and large choroidal vessels.• CONCLUSION: Smaller lesion size and better visual acuity at presentation were good predictive signs, whereas cystoid macular edema was found to be a poor A GE-RELATED MACULAR DEGENERATION IS THE LEADing cause of legal blindness in white persons aged 50 years and older in the United States, with choroidal neovascularization accounting for the majority of cases. [1][2][3] Photodynamic therapy (PDT) has been reported to result in vaso-occlusion of choroidal neovascularization, with minimal effect on the sensory retina and the retinal pigment epithelium. 4 The Treatment of Age-Related Macular Degeneration With PDT (TAP) Study Group 5,6 concluded that PDT is a safe and effective mode of treatment for patients with predominantly classic subfoveal choroidal neovascularization due to age-related macular degeneration.The purpose of this retrospective study was to evaluate the visual acuity of patients with subfoveal choroidal neovascularization caused by age-related macular degeneration after administration of PDT in a clinical setting. We also sought to identify possible predictive visual and angiographic factors for the outcome of this treatment. METHODSTHE STUDY WAS CONDUCTED AT OUTPATIENT OPHTHALmology clinics in a university-affiliated medical institution. We reviewed the clinical charts and fluorescein and indocyanine green angiographies of 74 consecutive patients with subfoveal choroidal neovascularization due to age-related macular degeneration who were treated with verteporfin PDT from

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Section: Our Findings Show That Pdt Is Well Tolerated In Amentioning

confidence: 96%

Section: Our Findings Show That Pdt Is Well Tolerated In Amentioning

confidence: 99%

Photodynamic therapy for age-related macular degeneration in a clinical setting: visual results and angiographic patterns

Axer‐Siegel

Ehrlich

Yassur

et al. 2004

American Journal of Ophthalmology

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“…7 In other longitudinal studies, OCT parameters, such as maximum retinal thickness, foveal thickness, or cystoid changes, were associated with decreased distance VA at baseline and follow-up. 5,12 Vision outcomes resulting from the treatment of AMD-CNV have been evaluated primarily by using the ETDRS 0.1 logMAR chart. [8][9][10] However, visual acuity is recognized to have significant limitations in evaluating vision, especially in the eye with macular disease.…”

Section: Introductionmentioning

confidence: 99%

Relationships between clinical measures of visual function and anatomic changes associated with bevacizumab treatment for choroidal neovascularization in age-related macular degeneration

Ünver

Yavuz

Bekiroğlu

et al. 2008

Eye

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Purpose This pilot study was undertaken to examine the relationships between clinical measures of visual function and anatomic changes occurring in the eyes treated with bevacizumab for choroidal neovascularization (CNV) due to age-related macular degeneration (AMD). Methods A retrospective review was conducted for 50 eyes that had been treated with at least three injections of bevicizumab for CNV due to AMD, and followed for at least 6 months. Vision outcomes included best-corrected ETDRS chart acuity, scored by best-line read (ETDRS line) and by total letters read (ETDRS letter), and two measures obtained from central acuity perimetry with 98% Michelson contrast targets, the best acuity within 61 of fixation (BA61), and global macular acuity (GMA), representing a weighted average of the acuities thresholded at all intercepts within a 101 radius of fixation. Assessment of anatomic outcomes included fibrosis, atrophy, and subretinal hemorrhage grading on fundus photography, CNV size, pigment epithelial detachment (PED) size and grading of CNV leakage on fluorescein angiography, and central retinal PED, and subretinal fluid (SRF) thickness on optical coherence tomography. Results Logistic regression analysis showed an association between the vision outcomes of EDTRS letter and BA61 with the change in SRF thickness (R 2 : 0.47 and 0.35, respectively). The outcome of the vision measurement of GMA was associated with the change in SRF thickness, in CNV thickness, and in CNV fibrosis grade (R 2 : 0.34). No association was noted between the outcomes of ETDRS line with the change in any anatomic outcomes. Conclusion Acuity perimetry outcomes in this study seemed to offer improved understanding of the relationship between the vision outcomes and the measured anatomic changes. It seemed that neither ocular coherence tomography nor fluorescein angiography alone offered sufficient morphologic markers for prediction of functional outcomes.

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“…Fluid accumulation in the retina results in retina thickening with or without clear cysts, while subretinal or sub-RPE fluid is seen as clear spaces in these locations. A previous report [9] indicated that cystoid macular edema was a common finding in patients with CNV secondary to AMD. Moreover, the presence of macular edema and resulting foveal thickening was associated with worse visual acuity in those patients.…”

Section: Introductionmentioning

confidence: 99%

Intraobserver Repeatability of Automated versus Adjusted Optical Coherence Tomography Measurements in Patients with Neovascular Age-Related Macular Degeneration

Tatlıpınar¹,

Shah²,

Campochiaro³

et al. 2007

Ophthalmologica

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Aim: To assess the intraobserver repeatability of automated versusadjusted optical coherence tomography (OCT) measurements in patients with neovascular age-related macular degeneration (NVAMD). Methods: Ten eyes with NVAMD from 10 consecutive patients underwent two OCT measurements within 5 days by a single operator. Automated and adjusted central 1-mm foveal thickness and automated and adjusted total macular volume were measured in each study eye. The term ‘adjusted’ refers to manually corrected values, in which the interface landmarks for measurements are selected by the operator using Stratus® scan profiling and custom software. Bland-Altman method and bootstrap comparison of intraclass correlations (ICCs) were used for repeatability analysis. Results: Bland-Altman comparison did not reveal any statistically significant difference in any parameter, when results at first and second examination were compared (p > 0.05), indicating that the repeated measurements are similar. Further analysis was conducted using the bootstrap comparison of ICCs. The difference between adjusted and automated foveal thickness ICCs (r = 0.945 and 0.635, respectively) was significant (p = 0.031), indicating higher repeatability for adjusted foveal thickness. The ICCs for adjusted and automated total macular volume (r = 0.873 and 0.863, respectively) showed no statistically significant difference (p = 0.881). Conclusion: The repeatability of adjusted retinal thickness measurements, in which the errors of retinal boundary detection by OCT analysis software is corrected by the operator using scan profiling, is found to be higher than that of automated ones in this small group of NVAMD patients when performed by a single experienced operator.

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Decreased Visual Acuity Associated With Cystoid Macular Edema in Neovascular Age-related Macular Degeneration

Cited by 96 publications

References 20 publications

Photodynamic therapy for age-related macular degeneration in a clinical setting: visual results and angiographic patterns

Photodynamic therapy for age-related macular degeneration in a clinical setting: visual results and angiographic patterns

Relationships between clinical measures of visual function and anatomic changes associated with bevacizumab treatment for choroidal neovascularization in age-related macular degeneration

Intraobserver Repeatability of Automated versus Adjusted Optical Coherence Tomography Measurements in Patients with Neovascular Age-Related Macular Degeneration

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