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RAP study, report 1: novel subtype of macular neovascularisation type III, cilioretinal MNV3
  1. Bilal Haj Najeeb,
  2. Gabor G Deak,
  3. Ursula Margarethe Schmidt-Erfurth,
  4. Bianca S Gerendas
  1. Vienna Reading Center. Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria
  1. Correspondence to Professor Ursula Margarethe Schmidt-Erfurth, Department of Opththalmology, Medical University Vienna, Vienna 1090, Austria;{at}


Purpose To report on patients with macular neovascularisation type III (MNV3) arising from cilioretinal arteries (CRAs) (cilioretinal macular neovascularisation type III (cMNV3)).

Methods We reviewed baseline examinations of patients with neovascular age-related macular degeneration using multimodal imaging. We determined the type and distribution of MNV lesions in each cMNV3 case, the range of distances from the fovea, existence of exudative maculopathy, intraretinal haemorrhage and other morphological characteristics. 50 consecutive eyes with usual MNV3 without CRA were included as a control group.

Results 102 eyes of 102 patients were identified with MNV3 lesions. Among these, we found 12 eyes (12%) with cMNV3, 84 eyes (82%) with usual MNV3 without CRA and 6 eyes (6%) with usual MNV3 with CRA. Ten cases of cMNV3 had one lesion, and two cases had two lesions. The lesions were distributed equally between the superior and inferior halves of the macula, whereas in the nasal and temporal halves, there were 8 (57%) and 6 (43%) lesions, respectively. All cMNV3 lesions were located between 500 and 1500 µm from the central fovea except one, which was located between 1500 and 3000 µm. None of the lesions had macular neovascularisation type I (MNV1) or macular neovascularisation type II (MNV2) elsewhere in both groups. Exudative maculopathy and intraretinal haemorrhage were found in seven (88%) and five (63%) of the eight pure cMNV3 cases, respectively.

Conclusion cMNV3 can be solitary or multiple, isolated or accompanied with usual MNV3 lesions, but not with concurrent MNV1 or MNV2. It is frequently associated with extensive exudative maculopathy, intraretinal haemorrhage and subretinal fluid.

  • retina
  • angiogenesis
  • imaging
  • macula
  • neovascularisation

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  • Presented at Part of this study was presented at the Association for Research in Vision and Ophthalmology 2018 meeting in Honolulu, USA, and was chosen by the scientific organisers as a hot topic.

  • Contributors BHN: idea, writing the manuscript, acquiring data, analyses of the results, interpretation of the data, contribution to the conception and design of the work. GD: acquisition of data, contribution to the conception and design of the work and critical revision of the manuscript. UMS-E: critical revision of the manuscript. BG: contribution to the conception and design of the work and critical revising of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval Ethical approval was obtained from each participating centre’s institutional review board for inclusion in the multicentre trials. The retrospective analysis of the data as part of the Vienna Reading Center imaging database was approved by the institutional review board of the Medical University of Vienna.

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Data availability statement No data are available.

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