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Types of Choroidal Neovascularization (CNV) in Newly Diagnosed Exudative Age-related Macular Degeneration (AMD)
  1. Salomon Y Cohen (sycohen{at}club-internet.fr),
  2. Catherine Creuzot-Garcher (catherine.creuzot-garcher{at}chu-dijon.fr),
  3. Jacques Darmon (jacques.darmon{at}wanadoo.fr),
  4. Thomas Desmettre (tjd{at}club-internet.fr),
  5. Jean-François Korobelnik (jean-francois.korobelnik{at}chu-bordeaux.fr),
  6. Fleur Levrat (fleur.levrat{at}pfizer.com),
  7. Gabriel Quentel (cilaser75{at}wanadoo.fr),
  8. Stephane Palies (stephane.palies{at}pfizer.com),
  9. Anne Sanchez (martine.kosa{at}pfizer.com),
  10. Anne Solesse de Gendre (anne.solessedegendre{at}pfizer.com),
  11. Helene Schluep (helene.schluep{at}pfizer.com),
  12. Michel Weber (michel.weber{at}chu-nantes.fr),
  13. Cecile Delcourt (cecile.delcourt{at}isped.u-bordeaux2.fr)
  1. Centre Ophtalmologique d'Imagerie et de Laser, Paris, France
  2. Dept of Ophthalmology, Dijon, France
  3. Centre d'imagerie et laser, Nice, France
  4. Centre d'imagerie et laser, lambersart, France
  5. Dept of Ophthalmology, Bordeaux, France
  6. Pfizer, France, France
  7. Centre Ophthalmologique d'Imagerie et de Laser, Paris, France
  8. Pfizer, France, France
  9. Biostatem, Nîmes, France
  10. Pfizer, France, France
  11. Pfizer, France, France
  12. Dept of Ophthalmology, Nantes, France
  13. ISPED, Bordeaux, France

    Abstract

    Aim: To describe the types and location of CNV in exudative AMD, including vascularized pigment epithelial detatchments (PED), and most recently described subtypes, such as retinal choroidal anasmostosis, also termed "retinal angiomatous proliferation" (RAP).

    Methods: Prospective multi-center consecutive descriptive case series. Two hundred and seven consecutive cases of newly diagnosed exudative AMD undergoing fluorescein angiography (FA) were recruited by 7 French referral hospital-based or private centers. 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. 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, i.e. vascularized PED (23.9%). Retinal angiomatous proliferation (RAP) were observed in 15.1% of cases, and accounted for 30% of vascularized PED. 5.8 % of the cases had hemorrhagic AMD and 4.8 % had fibrovascular scars. Lesions were mainly subfoveal (80 %). Agreement between the center's ophthalmologist and the final validated expert classification was moderate (kappa= 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.

    • Age-related macular degeneration
    • Choroidal neovascularization
    • Fluorescein angiography
    • Indocyanine green angiography
    • Retinal angiomatous proliferation

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