Long-term characteristics of exudative age-related macular degeneration in Japanese patients

Abstract

Purpose The present study aimed to evaluate the clinical characteristics of exudative age-related macular degeneration (AMD) in Japanese patients over a 10-year period and to compare the past our report. Methods We retrospectively reviewed 1,600 treatment-naïve patients (1,777 eyes) with exudative AMD. The 10 years were divided into 2-year phases I to V. Results Of the 1,600 patients, 720 (45.0%), 733 (45.8%), 98 (6.1%), and 49 (3.1%) were diagnosed with typical AMD, polypoidal choroidal vasculopathy (PCV), retinal angiomatous proliferation, and combined subtypes, respectively. The prevalence of PCV decreased from 54.7% in phase I to 46.0% at phase V. Of the 1,777 eyes, the mean baseline logarithm of the minimum angle of resolution best-corrected visual acuities (BCVAs) in phases I, II, III, IV, and V were 0.70, 0.66, 0.55, 0.50, and 0.48, respectively. Phases III, IV, and V had significantly (P = 0.0012, P<0.0001, P<0.0001, respectively) better baseline VAs compared with phase I. The mean lesion sizes in phases I, II, III, IV, and V were 8.6, 6.7, 5.3, 5.7, and 5.7 Macular Photocoagulation Study disc areas, respectively. The sizes were significantly (P<0.0001 for all comparisons) smaller in phases III, IV, and V compared with phase I. Conclusions Although the prevalence of PCV decreased from 54.7% in phase I to 46.0% at phase V, PCV has nevertheless been highly prevalent in Japanese patients with AMD compared with Caucasian patients. The annual better baseline VAs and smaller lesion sizes over time might be related to development of treatment and better concerns about AMD.

A case of intraocular inflammation after intravitreal brolucizumab injection monitored by laser flare-cell photometer

“…A high percentage of PCV is a major characteristic of Japanese patients with AMD. 4 , 5 The HAWK study subanalysis for PCV patients reported that eyes treated with brolucizumab had a probability of receiving an injection every 12 weeks for dosing after loading through weeks 48 and 96 of 76% and 68%, respectively. 11 According to the short-term results of PCV patients treated with brolucizumab, complete regression of polypoidal lesions was achieved in 15 of 19 eyes (78.9%) and 11 of 14 eyes (78.6%), which is superior to the results in the PLANET study (38.9% and 44.8%).…”

“… 1 , 2 , 3 A high proportion of polypoidal choroidal vasculopathy (PCV) is a major characteristic of Asian patients with AMD. 4 , 5 Intravitreal anti-vascular endothelial growth factor (VEGF) drugs, such as ranibizumab (Lucentis, Genentech, Inc., South San Francisco, CA, USA) and aflibercept (Eylea, Regeneron, Tarrytown, NY, USA, and Bayer, Berlin, Germany), are evidence-based therapy for exudative AMD. 6 , 7 , 8 Recently, the new anti-VEGF drug brolucizumab (beovu®, Novartis Pharma AG, Basel, Switzerland) was reported to be non-inferior to aflibercept in major clinical trials and became available for medical use in Japan in May 2020.…”

Blood flow pattern in eye before development of type 3 macular neovascularization

“…Thus, Sacconi et al [5] analyzed the OCTA findings at the nascent stage of type 3 MNV and reported that there was already hyperreflective material with blood flow information in the DCP or OR before the exudation developed, i.e., the non-exudative type 3 MNV stage. Although the incidence of type 3 MNV is low in Japanese patients [8,9], Kataoka et al [10] reported a stage 1 case of type 3 MNV in the OCTA images in a Japanese patient. They showed the presence of blood flow pattern originating from the DCP in the OCTA images.…”

Pachychoroid neovasculopathy has clinical properties that differ from conventional neovascular age-related macular degeneration

“…Now they are classified as type 1 MNV, type 2 MNV, type 3 MNV, and PCV as subtypes of type 1 MNV 1 . An earlier study that examined the percentage of each subtype of MNV secondary to AMD in the Japanese population reported that the type 1 and type 2 MNVs accounted for 45%, PCV accounted for another 45%, and type 3 MNV (RAP) accounted for about 6% 2 , 3 . The proportion of the PCV and type 3 MNV (RAP) types in the Japanese population differed significantly from that in Western countries, and the MNV secondary to AMD patients in Asia had fewer drusen-associated disease and more with prior central serous chorioretinopathy than in the Western countries 4 .…”