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Clinical science
Type 3 neovascularisation: long-term analysis of visual acuity and optical coherence tomography anatomical outcomes
  1. Bora Chae1,
  2. Daniel Su1,
  3. Orly Gal-Or2,3,4,
  4. K Bailey Freund2,3,5,
  5. David Sarraf1,6
  1. 1 Stein Eye Institute, University of California, Los Angeles, California, USA
  2. 2 Vitreous, Retina Macula, Consultants of New York, New York City, New York, USA
  3. 3 LuEsther T Mertz Retinal Research Center, Manhattan Eye, Ear and Throat Hospital, New York, New York, USA
  4. 4 Department of Ophthalmology, Rabin Medical Center, Petach Tikva, Israel
  5. 5 Department of Ophthalmology, New York University School of Medicine, New York, New York, USA
  6. 6 Department of Ophthalmology, Kaiser Permanente, Woodland Hills, California, USA
  1. Correspondence to Dr David Sarraf, Retinal Disorders and Ophthalmic Genetics Division, Stein Eye Institute, UCLA Geffen School of Medicine, Los Angeles, CA 90095, USA; dsarraf{at}ucla.edu

Abstract

Background To investigate the long-term visual and optical coherence tomography (OCT) anatomical outcomes of type 3 neovascularisation (NV) and to identify any baseline predictors of poor outcomes.

Methods In this retrospective study, patients diagnosed with treatment naïve type 3 NV were identified and categorised into two groups: good or poor vision based on final vision at 1 year. Baseline demographic features and visual acuity (VA) and baseline and 1-year spectral domain OCT (SD-OCT) anatomical findings were studied and correlated with good versus poor visual outcomes.

Results Ten of 25 eyes were classified as having a poor visual outcome (20/50 or worse) at 1 year. Increased age (P=0.049), male gender (p=0.041) and worse baseline VA (ρs=0.61, p=0.001) were associated with poor vision at 1 year. Greater foveal atrophy was noted at 1 year in the poor visual outcome group (p=0.030). Subretinal hyper-reflective material and choroidal thinning were additional features noted more commonly in this group.

Conclusion Increased age, male gender and lower baseline vision may be important baseline predictors of poor visual outcomes in eyes with type 3 NV. The development of central outer retinal atrophy and fibrosis, as identified with SD-OCT, may limit long-term vision in eyes with type 3 NV.

  • macula
  • neovascularisation
  • angiogenesis
  • imaging
  • vision

https://doi.org/10.1136/bjophthalmol-2018-311850

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    Footnotes

    • Contributors Acquisition of data: BC, D Su and OG-O. Conceptualisation of manuscript and review of literature: BC, KBF and D Sarraf. Drafting and editing of the manuscript: BC, D Su, OG-O, KBF and D Sarraf. Data analysis and interpretation: BC and D Su.

    • Funding The Macula Foundation, New York, New York, USA.

    • Competing interests KBF is a consultant for Genentech, Optovue, Optos, Spark Therapeutics and Heidelberg Engineering. He receives research support from Genentech/Roche. D Sarraf is a consultant for Amgen, Bayer, Novartis, Genentech and Optovue and receives research funding from Allergan, Genentech, Heidelberg, Optovue and Regeneron. BS, D Su, OG-O: none declared.

    • Patient consent Detail has been removed from this case description/these case descriptions to ensure anonymity. The editors and reviewers have seen the detailed information available and are satisfied that the information backs up the case the authors are making.

    • Ethics approval Approved by the Institutional Review Boards from Vitreous Retina Macula Consultants of New York (Western IRB, Olympia, Washington, USA), University of California Los Angeles (UCLA IRB, Los Angeles, California, USA) and Kaiser Permanente (IRB at Kaiser Permanente Medical Center, Woodland Hills, California, USA).

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

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