The RAP study, report 4: morphological and topographical characteristics of multifocal macular neovascularization type 3

Abstract

Purpose To report on the morphological characteristics and regional distribution of multifocal macular neovascularization type 3 (mMNV3). Methods Twenty-two consecutive eyes of 21 patients with mMNV3 were included using multimodal imaging. The count and stage of lesions of all MNV types and the existence of exudate and hemorrhage were determined. Also, we addressed the regional distribution of MNV3 lesions between the superior-inferior and the nasal-temporal halves of the macula, and the range of the distance of the lesions from the central fovea. Furthermore, we explored the number of feeding vessels including the cilioretinal artery. Results We found 51 lesions in 22 eyes of 21 patients. They were bifocal in 16 (73%) eyes, trifocal in 5 (23%), and quadrifocal in one (4%). No lesion of MNV1 or 2 was found. Fifteen (68%), 2 (9%), and 16 (73%) eyes were associated with retinal hard exudate, subretinal pigment epithelium exudate, and intraretinal hemorrhage, respectively. Thirty (59%) lesions were located in the temporal half of the macula, whereas 21 (41%) were located nasally (p = 0.07). One (2%) lesion was closer than 500 µm, 49 (96%) between 500 and 1500 µm, and one (2%) between 1500 and 3000 µm. The lesions were supplied by one arteriole in one (4%) eye, two arterioles in 16 (73%) eyes, and 3 arterioles in 5 (23%) eyes. The CRA contributed as a feeding vessel in 5 (23%) eyes. Conclusion The multifocal variant of MNV3 has specific morphological and topographical characteristics. Multimodal imaging allows the understanding of the pathomorphological condition in more detail.

The Rap Study, Report 5: Rediscovering Macular Neovascularization Type 3

“…Nevertheless, we found that there was no MNV1 or MNV2 elsewhere in eyes with MNV3 lesions. This finding correlates with our findings on solitary, cilioretinal, and multifocal MNV3, 5,6,8 which indicate that the main predisposing factors of this type are different from those of MNV1 and MNV2, or the development of MNV1 or MNV2 prevents the progression of MNV3.…”

Correspondence

“…These lesions are distributed from 500 to 1,500 µ m from the center and likely cause more fluid than an eye with one lesion would show. 11 Did the authors verify the distribution of this phenotype in both groups because it could also cause a bias when central macular thickness measurements were compared between groups?…”

Histology of type 3 macular neovascularization and microvascular anomalies in treated age-related macular degeneration: a case study

“…The copyright holder for this this version posted September 15, 2022. ; https://doi.org/10.1101/2022.09. 13…”

“…Macrophages, VEGF-positive fibroblasts, lymphocytes, Müller cell processes, and subducted RPE cells were identified. 12, 13 Hence, ischemia and inflammatory pathways were suggested in the development and progression of type 3 MNV. 12, 13…”

“…12, 13 Hence, ischemia and inflammatory pathways were suggested in the development and progression of type 3 MNV. 12, 13…”