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