Occult Choroidal Neovascularization in Age-Related Macular Degeneration

Stevens, Thomas S.; Bressler, Neil M.; Maguire, Maureen G.; Bressler, Susan B.; Fine, Stuart L.; Alexander, Judith; Phillips, Deborah; Margherio, Raymond R.; Murphy, Patrick L.; Schachat, Andrew P.

doi:10.1001/archopht.1997.01100150347006

Cited by 108 publications

(70 citation statements)

References 10 publications

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“…[32][33][34][35] Disease progression has been discussed in terms of individual differences in location and lateral extent of a neovascular lesion, and also in associated changes of the choriocapillaris, Bruch's membrane and retinal pigment epithelium. 36 Some of our cases had juxtafoveal or extrafoveal location of the CNV.…”

Section: Discussionmentioning

confidence: 99%

Relationship between foveal birefringence and visual acuity in neovascular age-related macular degeneration

Weber

Elsner

Miura

et al. 2006

Eye

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Purpose To investigate the relationship between visual acuity and foveal birefringence in patients with neovascular age-related macular degeneration. Methods In total, 40 patients with choroidal neovascularization underwent macular imaging with scanning laser polarimetry. Bowtie patterns, typically seen in birefringence images of the macula, were evaluated and classified into three categories: (1) regular bowtie present; (2) bowtie present, but disrupted; and (3) no bowtie present. The relation of the bowtie appearance to the best-corrected logMAR visual acuities was tested (ANOVA). Results Mean visual acuity was best for the group that had regular bowties (mean logMAR ¼ 0.34) and differed statistically significantly from the disrupted bowtie group and no bowtie group (P ¼ 0.01 and 0.0007). Ages for the three groups did not differ (P ¼ 0.31). Conclusions Appearance of a regular bowtie indicates a substantially intact Henle fibre layer with the potential for good visual function, despite the presence of underlying pathology. Conversely, disruption or absence of a bowtie may indicate severe damage to the photoreceptors, consistent with the finding of poorer visual acuity.

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Section: Discussionmentioning

confidence: 99%

Relationship between foveal birefringence and visual acuity in neovascular age-related macular degeneration

Weber

Elsner

Miura

et al. 2006

Eye

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“…However, with time, well-defined areas of hyperfluorescence often develop within occult CNV, suggesting a transition from CNV beneath the RPE to that within the neurosensory retina. When this occurrs, there is usually a rapid decline in vision (Stevens et al, 1997). Later histopathologic analyses of surgical and ocular specimens show strong correlations between the fundus and fluorescein angiographic appearances and the location of CNV, either above or below the RPE.…”

Section: Classification Of Neovascular Amd: the Importance Of Rpe-ec mentioning

confidence: 99%

“…This led to the classification of CNV lesions as type 1, beneath the RPE, type 2, above the RPE and beneath the neurosensory retina, or a combined form (Grossniklaus and Gass, 1998;Grossniklaus and Green, 2004). The reason why distinction between these types of CNV is important is that occult CNV can be associated with good vision until the transition to neurosensory retinal CNV occurs (Stevens et al, 1997). Since VEGF is a survival factor for RPE and CECs, inhibition of all its bioactivity may not be desirable.…”

Section: Classification Of Neovascular Amd: the Importance Of Rpe-ec mentioning

confidence: 99%

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Vascular endothelial growth factor in eye disease

Penn

Madan

Caldwell

et al. 2008

Progress in Retinal and Eye Research

615

527

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Collectively, angiogenic ocular conditions represent the leading cause of irreversible vision loss in developed countries. In the U.S., for example, retinopathy of prematurity, diabetic retinopathy and age-related macular degeneration are the principal causes of blindness in the infant, working age and elderly populations, respectively. Evidence suggests that vascular endothelial growth factor (VEGF), a 40 kDa dimeric glycoprotein, promotes angiogenesis in each of these conditions, making it a highly significant therapeutic target. However, VEGF is pleiotropic, affecting a broad spectrum of endothelial, neuronal and glial behaviors, and confounding the validity of anti-VEGF strategies, particularly under chronic disease conditions. In fact, among other functions VEGF can influence cell proliferation, cell migration, proteolysis, cell survival and vessel permeability in a wide variety of biological contexts. This article will describe the roles played by VEGF in the pathogenesis of retinopathy of prematurity, diabetic retinopathy and age-related macular degeneration. The potential disadvantages of inhibiting VEGF will be discussed, as will the rationales for targeting other VEGF-related modulators of angiogenesis.

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“…One study 17 demonstrated that, after 9-12 months of follow-up, 32% of occult lesions more than double their size, the median loss in visual acuity was 2.5 lines and approximately 50% of pure occult lesions developed classic CNV.…”

Section: Discussionmentioning

confidence: 99%

Low power vs standard power transpupillary thermotherapy in patients with age-related macular degeneration and subfoveal choroidal neovascularization ineligible for photodynamic therapy

Hogan

Kilmartin

2005

Eye

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Aim To assess the effect of standard power vs low power transpupillary thermotherapy (TTT) in patients with active subfoveal choroidal neovascularization secondary to age-related macular degeneration ineligible for photodynamic therapy (PDT) by original treatment of age-related macular degeneration with photodynamic therapy (TAP) study group recommendations. Methods Retrospective review of 79 patients with active predominantly occult subfoveal choroidal neovascularization or predominantly classic subfoveal choroidal neovascularization but Snellen visual acuity o20/200. All patients were treated with TTT administered via a Mainster wide field fundus contact lens with a retinal power/diameter coefficient of 248 mW/mm in the standard power (n ¼ 27) and 181 mW/mm in the low power group (n ¼ 52). The primary outcome was stabilization (o1 Snellen line change) or improvement (two or more Snellen lines) in visual acuity. Clinical and fluorescein angiographic resolution of overlying exudation was documented. Results At 24 month follow-up, 17 patients (63%) in the standard power and 36 patients (69%) in the low power group achieved stable or improved vision. Improved vision (mean three lines) was observed in 22% of the standard power and 23% of the low power group. Overlying exudation was reduced clinically with minimal or no leakage on fluorescein angiogram in 85% of standard power and 90% of low power group. Subgroup analysis in the low power group demonstrated a visual benefit in patients with subfoveal lesions, which had any classic component. Conclusions Low power TTT is as effective as standard power in stabilizing or improving vision and reducing overlying exudation in patients with active subfoveal choroidal neovascularization ineligible for PDT.

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Occult Choroidal Neovascularization in Age-Related Macular Degeneration

Cited by 108 publications

References 10 publications

Relationship between foveal birefringence and visual acuity in neovascular age-related macular degeneration

Relationship between foveal birefringence and visual acuity in neovascular age-related macular degeneration

Vascular endothelial growth factor in eye disease

Low power vs standard power transpupillary thermotherapy in patients with age-related macular degeneration and subfoveal choroidal neovascularization ineligible for photodynamic therapy

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