Do We Need a New Classification for Choroidal Neovascularization in Age-Related Macular Degeneration?

Freund, K. Bailey; Zweifel, Sandrine; Engelbert, Michael

doi:10.1097/iae.0b013e3181e7976b

Cited by 366 publications

(310 citation statements)

References 54 publications

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“…He introduced the terms type I CNV to describe new vessels developing in the sub-RPE space, and type II for new vessels developing above the RPE. 45 Following the advent of multimodal imaging, especially SD-OCT, Freund et al 46 proposed a shift in the classification of Eye neovascularization towards Gass' histologic classification. They added a third entity, intraretinal neovascularization, also known as RAP, and lesions with more than one neovascular type (mixed neovascularization).…”

Section: Eyementioning

confidence: 99%

Risk of geographic atrophy in age-related macular degeneration patients treated with intravitreal anti-VEGF agents

Gemenetzi

Lotery

Patel

2016

Eye

104

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Anti-vascular endothelial growth factor (VEGF) intravitreal agents are the only successful treatment for wet age-related macular degeneration (AMD). However, there are emerging signals that anti-VEGF treatment can potentially increase development of geographic atrophy (GA). Histopathologic, animal, and clinical studies support this hypothesis although direct proof of a relationship between GA and use of anti-VEGF agents in neovascular AMD is not yet established. This review presents current evidence supporting an association between anti-VEGF therapy and progression of geographic atrophy. The need of exploring alternative methods of treating AMD is indirectly but clearly emphasized.

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Section: Eyementioning

confidence: 99%

Risk of geographic atrophy in age-related macular degeneration patients treated with intravitreal anti-VEGF agents

Gemenetzi

Lotery

Patel

2016

Eye

104

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“…2,3 Type 2 neovascularization in AMD originates from the choroid, but is present above the retinal pigment epithelium in the subretinal compartment. 5 In this study, we employed SSADA technology to study a type 2 neovascular membrane before and after ranibizumab therapy in a patient with AMD.…”

Section: Introductionmentioning

confidence: 99%

OCT angiography and sequential quantitative analysis of type 2 neovascularization after ranibizumab therapy

Kuehlewein

Sadda

Sarraf

2015

Eye

119

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Purpose To study the precise structural aspects of a type 2 neovascular membrane in a patient with age-related macular degeneration (AMD) using optical coherence tomography (OCT) angiography and perform sequential quantitative analysis of the membrane after ranibizumab therapy. Patients and methods Split-spectrum amplitude-decorrelation (SSADA) OCT angiography macular cubes (3 × 3 mm) were acquired with a light source centered at 840 nm, a bandwidth of 45 nm, and an A-scan-rate of 70 000 scans per second. Visible pathologic vessels were outlined manually on average intensity projection en face images, and the area of the lesion and the vessel density were measured at baseline and follow-up. Results At baseline, the neovascular lesion measured 4.12 mm 2 and the vessel density was 19.83 mm ), although the large central trunks of the lesion were unchanged. Conclusions In this study, an obvious reduction in size and vessel density of the neovascular lesion was noted after treatment with ranibizumab using SSADA OCT angiography technology. Microvascular components can be delineated with precision, suggesting that this technique may be useful for the management of patients with neovascular AMD in a clinical setting as well as for future clinical trials.

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“…Neovascularisation (associated frequently, but not exclusively, with AMD) has been classified as type 1 (below the RPE), type 2 (above the RPE, in the subretinal space) and type 3 (also termed retinal angiomatous proliferation), with SD-OCT being the imaging modality most suited to establishing this distinction in vivo Type 1 membranes appear most likely to be associated with drusen or the subclinical deposits mentioned in the Section 2; a recent histopathological study confirmed the presence of basal laminar deposits in type 1 neovascularisation . Other types may develop in absence of drusen or may be associated with the presence of subretinal drusenoid deposit (Freund et al, 2010).…”

mentioning

confidence: 99%

Differentiating drusen: Drusen and drusen-like appearances associated with ageing, age-related macular degeneration, inherited eye disease and other pathological processes

Khan

Mahroo

Khan

et al. 2016

Progress in Retinal and Eye Research

179

159

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Drusen are discussed frequently in the context of their association with age-related macular degeneration (AMD). Some types may, however, be regarded as a normal consequence of ageing; others may be observed in young age groups. They also occur in a number of inherited disorders and some systemic conditions. Whilst drusen are classically located external (sclerad) to the retinal pigment epithelium, accumulations of material internal (vitread to) this layer can display a drusen-like appearance, having been variously termed pseudodrusen or subretinal drusenoid deposits. This review first briefly presents an overview of drusen biogenesis and subclinical deposit. The (frequently overlapping) subtypes of clinically detectable deposit, seen usually in the context of ageing or AMD, are then described in more detail, together with appearance on imaging modalities: these include hard and soft drusen, cuticular drusen, reticular pseudodrusen and "ghost drusen". Eye disorders other than AMD which may exhibit drusen or drusen-like features are subsequently discussed: these include monogenic conditions as well as conditions with undefined inheritance, the latter including some types of early onset drusen such as large colloid drusen. A number of systemic conditions in which drusen-like deposits may be seen are also considered. Throughout this review, high resolution images are presented for most of the conditions discussed, particularly the rarer ones, providing a useful reference library for images of the range of conditions associated with drusen-like appearances. In the final section, some common themes are highlighted, as well as a brief discussion of some future avenues for research.

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Do We Need a New Classification for Choroidal Neovascularization in Age-Related Macular Degeneration?

Cited by 366 publications

References 54 publications

Risk of geographic atrophy in age-related macular degeneration patients treated with intravitreal anti-VEGF agents

Risk of geographic atrophy in age-related macular degeneration patients treated with intravitreal anti-VEGF agents

OCT angiography and sequential quantitative analysis of type 2 neovascularization after ranibizumab therapy

Differentiating drusen: Drusen and drusen-like appearances associated with ageing, age-related macular degeneration, inherited eye disease and other pathological processes

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