Unaffected fellow eye neovascularization in patients with type 3 neovascularization: Incidence and risk factors

Abstract

Purpose To evaluate the incidence and risk factors of neovascularization in unaffected fellow eyes of patients diagnosed with type 3 neovascularization in Korea. Methods This retrospective study included 93 unaffected fellow eyes of 93 patients diagnosed with type 3 neovascularization. For initial type 3 neovascularization diagnosis, optical coherence tomography and angiography were conducted. These baseline data were compared between patients with and without neovascularization in their fellow eyes during the follow-up period. Results The mean follow-up period was 66.1±31.1 months. Neovascularization developed in 49 (52.8%) fellow eyes after a mean period of 29.5±19.6 months. In the fellow eye neovascularization group, the incidence of soft drusen and reticular pseudodrusen was significantly higher than that in the non-neovascularization group (83.7% vs. 36.5%, p<0.001; 67.3% vs. 40.9%, p = 0.017, respectively), but the choroidal vascularity index (CVI) showed a significantly lower value (60.7±2.0% vs. 61.7±2.5%; p = 0.047). The presence of reticular pseudodrusen was related with the duration from baseline to development of fellow eye neovascularization (p = 0.038). Conclusion Neovascularization developed in 52.8% of unaffected fellow eyes. The presence of soft drusen, reticular pseudodrusen, and lower CVI values can be considered risk factors of neovascularization in unaffected fellow eyes of patients with type 3 neovascularization. The lower CVI values suggest that choroidal ischemic change may affect the development of choroidal neovascularization in these patients.

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

“…Although one patient, the clinical and imaging characteristics are typical of multifocal type 3 MNV, including bilaterality (55% of cases) 44 and absence of type 1 MNV. 11-13, 44, 45 Type 3 MNV is distinguished by intraretinal origin, 1,2,46 frequent near-term bilateral involvement, [7][8][9] and significant choroidal thinning with reduced perfusion. 47,48 Patients with type 3 MNV are older at initial diagnosis than patients with type 1 MNV.…”

“…Table S3 shows internal and external vessel diameters of type 3 MNV and DRAMA, as well as DCP vessels in the index case and donor eyes (8 S3A) eyes. In DRAMA, external vessel diameters of OS 1 and OS 3 (13.39 µm ± 2.68 µm; 17.97 µm ± 1.08 µm) are considerably larger than the comparison vessels.…”

“…7 Fellow eyes often convert to neovascular AMD within 3 years. [8][9][10] Early lesions respond well to intravitreal anti-vascular endothelial growth factor (VEGF) therapy, unlike chronic lesions. 3,11 Recent clinical imaging studies have elucidated type 3 MNV pathophysiology.…”

“…Fellow eyes often convert to neovascular AMD within 3 years. [7][8][9] Early lesions respond well to intravitreal anti-vascular endothelial growth factor (VEGF) therapy, unlike chronic lesions. 2,10 New information about type 3 MNV and related vascular anomalies from histopathology, as provided herein, could support improved detection and treatment decisions in affected patients.…”

Histology of Type 3 Macular Neovascularization and Microvascular Anomalies in Treated Age-Related Macular Degeneration

“…Fellow eyes often convert to neovascular AMD within 3 years. 7 , 8 , 9 Early lesions respond well to intravitreal anti-VEGF therapy, unlike chronic lesions. 2 , 10 New information about type 3 MNV and related vascular anomalies from histopathology, as provided here, could support improved detection and treatment decisions in affected patients.…”