The Incidence of Neovascular Subtypes in Newly Diagnosed Neovascular Age-Related Macular Degeneration

Jung, Jesse J.; Chen, Christine Y.; Mrejen, Sarah; Gallego-Pinazo, Roberto; Xu, Leon; Marsiglia, Marcela; Boddu, Sucharita; Freund, K. Bailey

doi:10.1016/j.ajo.2014.07.006

Cited by 175 publications

(138 citation statements)

References 57 publications

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“…In Brazil, there are no reports on the epidemiologic or clinical features of RAP. The proportion (9.2%) of patients with RAP in the present study is higher than that in Asian studies [8,24,32,33] but lower than that observed in the studies by Yannuzzi et al [6] (which involved American patients with exudative AMD), Cohen et al [34] (which involved French patients with exudative AMD) and Freund and colleagues [36] (which involved American patients with exudative AMD). …”

Section: Discussioncontrasting

confidence: 81%

Characteristics of Neovascular Age-Related Macular Degeneration in Brazilian Patients

et al. 2015

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Purpose: To report features of neovascular age-related macular degeneration (AMD) in Brazilian patients. Procedures: Data were prospectively collected from patients diagnosed with neovascular AMD. Eyes were classified as having typical neovascular AMD, polypoidal choroidal vasculopathy (PCV), or retinal angiomatous proliferation (RAP). Results: In total, 265 eyes of 207 patients of predominantly Caucasian ancestry were included; 166 (62.6%) eyes had typical neovascular AMD, 65 (24.5%) eyes had PCV, and 34 (12.8%) eyes had RAP. RAP demonstrated a higher percentage of bilateral cases (p = 0.015). The mean foveal subfield thickness was significantly lower in eyes with PCV (p < 0.001). Cases with typical neovascular AMD had a higher percentage of predominantly classic and minimally classic lesions on fluorescein angiography (FA; p = 0.005). Conclusions: In Brazilian patients, PCV and RAP represented 24.5 and 12.8% of neovascular AMD cases. Neovascular AMD subtypes differ in relation to clinical features, mean foveal subfield thickness and FA presentation.

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Section: Discussioncontrasting

confidence: 81%

Characteristics of Neovascular Age-Related Macular Degeneration in Brazilian Patients

et al. 2015

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“…In 6 eyes, patients did not remember the date of symptom onset. According to the anatomical classification (based on FA and conventional OCT), 8 the neovascularization subtype was graded as follows: type I in 5 eyes (16%); type II in 11 eyes (35%); type III in 9 eyes (29%); and mixed in 6 eyes (19%).…”

Section: Resultsmentioning

confidence: 99%

“…The neovascularization subtypes were classified in accordance with the previously described scheme by Freund et al 7,8 by two of the readers (ML, MP) and a senior reader (MF) in case of discrepancy. In brief, type I neovascularizations were defined by an elevated RPE line in the OCT, often with subretinal fluid and an early stippled hyperfluorescence with mild to moderate staining or leakage in the late phase observed in the FA.…”

Section: Image Gradingmentioning

confidence: 99%

“…Type III was defined by intraretinal hyperreflective spots and cysts on OCT together with early focal leakage on the FA. 8 …”

Section: Image Gradingmentioning

confidence: 99%

“…5,6 Recently, an anatomical classification for neovascular AMD has been proposed based on the additional information obtained from the cross-sectional lesion morphology as visualized by optical coherence tomography (OCT). 7,8 However, conventional OCT devices do not allow direct visualization of the neovascular network; signs are rather indirect, such as intra-or subretinal fluid or pigment epithelial detachments. Fluorescein angiography is still considered the clinical gold standard when first diagnosing neovascular AMD.…”

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confidence: 99%

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OCT Angiography–Based Detection and Quantification of the Neovascular Network in Exudative AMD

Lindner

Fang

Steinberg

et al. 2016

Invest. Ophthalmol. Vis. Sci.

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Citation: Lindner M, Fang PP, Steinberg JS, et al. OCT angiography-based detection and quantification of the neovascular network in exudative AMD. Invest Ophthalmol Vis Sci. 2016;57:6342-6348. DOI:10.1167/ iovs.16-19741 PURPOSE. To investigate the potential of optical coherence tomography (OCT) angiography to detect and quantify the neovascular network in exudative AMD.METHODS. Treatment-naïve eyes that were diagnosed with exudative AMD were prospectively examined by OCT angiography (OCT-A). The extent of the neovascular network was measured by three independent readers. Interclass-correlation coefficient and area overlap coefficients (OC) were calculated to assess locally precise agreement between measurements. As a reference for interreader agreement, the extent of the neovascular network was further measured on fluorescein angiography (FA) images. RESULTS.A total of 31 eyes (27 patients, mean age 82.5 years, 15 female) were included in the study. Neovascularization subtype was classified as type I in 5, type II in 11, type III in 9, and mixed in 6 eyes, respectively. Interreader agreement for measurements of the neovascular network was 0.

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Association of Choroidal Neovascularization and Central Serous Chorioretinopathy With Optical Coherence Tomography Angiography

et al. 2015

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IMPORTANCE Choroidal neovascularization (CNV) is a major cause of vision loss in chronic central serous chorioretinopathy (CSCR). Detecting CNV using fluorescein angiography (FA) may be challenging owing to the coexistence of features related to the primary diagnosis of CSCR. Optical coherence tomography angiography (OCTA) allows noninvasive visualization of retinal and choroidal vasculature via motion contrast and may contribute to the unequivocal diagnosis of CNV in this population.OBJECTIVE To evaluate the sensitivity of spectral-domain OCTA in detecting CNV associated with chronic CSCR. DESIGN, SETTING, AND PARTICIPANTSObservational cross-sectional study including 23 patients (27 eyes) who presented at the New England Eye Center between August 1, 2014, and November 30, 2014, with suspected CNV complicating chronic CSCR and underwent standard assessment for CNV diagnosis, including FA imaging. Participants were prospectively recruited to receive imaging tests using prototype OCTA software on a commercially available spectral-domain OCT. Orthogonal registration and the merging of 2 consecutive image sets were used to obtain 3 × 3-mm and 6 × 6-mm OCT angiograms centered at the macula. Two independent readers masked to other imaging findings performed a qualitative analysis on OCTA depictions of vascular flow representing CNV and the morphologic appearance of CNV. MAIN OUTCOMES AND MEASURESChoroidal neovascularization location as well as retinal pigment epithelial detachment internal reflectivity and the presence of subretinal and intraretinal fluid. Sensitivity and specificity of OCTA in detecting CNV were estimated using FA as the standard examination reference.RESULTS Choroidal neovascularization was diagnosed in 8 of 27 eyes (30%) based on FA imaging analysis. Optical coherence tomography angiography and corresponding OCT B-scans detected 100% (8 of 8) of these CNV lesions and correctly excluded 100% (19 of 19) of eyes with CSCR without CNV. Sensitivity was 100% (95% CI, 0.62-1) and specificity was 100% (95% CI, 0.82-1). Morphologic appearance, location, and position of the CNV relative to the retinal pigment epithelium and Bruch membrane were described using OCTA that combined flow and structural information.CONCLUSIONS AND RELEVANCE This study suggests that OCT alone (OCTA and coregistered OCT B-scans) features sensitivity and specificity comparable with FA for the detection of CNV in eyes with chronic CSCR.

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The Incidence of Neovascular Subtypes in Newly Diagnosed Neovascular Age-Related Macular Degeneration

Cited by 175 publications

References 57 publications

Characteristics of Neovascular Age-Related Macular Degeneration in Brazilian Patients

Characteristics of Neovascular Age-Related Macular Degeneration in Brazilian Patients

OCT Angiography–Based Detection and Quantification of the Neovascular Network in Exudative AMD

Association of Choroidal Neovascularization and Central Serous Chorioretinopathy With Optical Coherence Tomography Angiography

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