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Retinal angiomatous proliferation- incidence and phenotype of neovascularization in the fellow-eye

Session Details

Session Title: Quick Fire Free Paper 3

Session Date/Time: Thursday 11/09/2014 | 14:30-16:00

Paper Time: 14:35

Venue: Boulevard D

First Author: : I.Laíns PORTUGAL

Co Author(s): :    J.P. Marques   M. Costa   I. Pires   M. Cachulo   J. Figueira   R. Silva

Abstract Details

Purpose:

To compare the incidence and phenotype of neovascularization (NV) between fellow eyes of unilateral retinal angiomatous proliferation (RAP) and typical exudative age-related macular degeneration (tAMD) and also to identify fundoscopic changes associated with the development of NV in RAP fellow-eyes.

Setting:

Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal. Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal.

Methods:

Retrospective study. After assessment of our database, seventy-nine fellow-eyes (study eyes) of patients with unilateral tAMD (group 1, n=40) and RAP (group 2, n=39) were included. All medical records were reviewed and incidence of NV in the study eye was registered when it was confirmed by optical coherence tomography, fluorescein angiography and indocyanine green-angiography. To assess baseline fundoscopic changes and associated risk to conversion, study-eyes’ color fundus photographs at the time of diagnosis of NV in the first eye were retrospectively analyzed. Classification was performed by a certified grader, using an innovative semiautomated software – RetmarkerAMD (Critical Health, SA, Portugal). The diagnosis of AMD NV phenotypes were double-checked using multimodal retinal imaging.

Results:

The incidence of NV was 50% in group 1 and 38.5% in group 2, during a mean follow-up of 88.8 ± 25.7 and 32.8 ± 20.9 months, respectively. In spite of the shorter follow-up, time to conversion was significantly lower in the RAP group (chi2=8.88; Pr>chi2=0.003). In this group, the NV phenotype of the fellow-eye was tAMD in 80%, polypoid choroidal vasculopathy in 15% and RAP in 5% of the patients. In group 2, it was RAP in 73.3% and tAMD in 26.7% of the patients. Baseline total number and area of drusen were significantly lower in fellow-eyes of RAP group (p<0.05). In this group, presence of drusen ≥ 125 µm in a total area > 510.2 µm2 was associated with a higher risk of NV (hazard ratio 4.84, 95% CI [1.66; 14.07, p=0.004].

Conclusions:

The risk of neovascularization is significantly higher in fellow-eyes of RAP but the neovascular phenotype is not always RAP. A higher total area of drusen with more than 125 µm is significantly associated with higher risk to conversion.

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