Aim: To describe the types and location of choroidal neovascularisation (CNV) in exudative age-related macular degeneration (AMD), including vascularised pigment epithelial detatchments (PED), and most recently described subtypes, such as retinal choroidal anasmostosis, also termed “retinal angiomatous proliferation” (RAP).
Methods: Prospective multicentre consecutive descriptive case series. A total of 207 consecutive cases of newly diagnosed exudative AMD undergoing fluorescein angiography (FA) were recruited by 7 French referral hospital-based or private centres. Indocyanine green angiography (ICG) also was performed, when judged necessary by investigators. Types and location of CNV were classified by two independent experts and adjudicated by a third when discordant.
Results: All patients had FA, while ICG was performed in 50% of subjects. A total of 17.6% had classic CNV only, 5.4% and 8.3% had predominantly and minimally classic CNV, respectively. Occult CNV could be classified in occult CNV without PED (32.7%) and occult CNV with PED, ie, vascularised PED (23.9%). RAP was observed in 15.1% of cases, and accounted for 30% of vascularised PED. In 5.8% of the cases there was haemorrhagic AMD and 4.8% had fibrovascular scars. Lesions were mainly subfoveal (80%). Agreement between the centre’s ophthalmologist and the final validated expert classification was moderate (κ = 0.52 for location and 0.59 for type of lesion).
Conclusion: This study confirms that newly diagnosed cases of exudative AMD are mainly occult and subfoveal. RAP appeared as a common lesion in patients with newly diagnosed exudative AMD.
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Competing interests: None declared.
SYC, CC-G, JD, CD, TD, JFK, GQ, MW and AS are consultants for Pfizer, France. HS, SP, ASdeG and FL are employees of Pfizer, France.
age-related macular degeneration
indocyanine green angiography
pigment epithelial detatchments
retinal angiomatous proliferation
vascular endothelial growth factor