Author: Maria Brambati (Italy)
Co-authors: Riccardo Sacconi, Alexandra Miere, Mariacristina Parravano, Eric Souied, Francesco Bandello, Giuseppe Querques
Purpose
To characterize macular neovascularization (MNV) developing in eyes affected by geographic atrophy (GA).
Setting/Venue
This is a multicentric longitudinal study involving 3 retina referral centers (the Medical Retina and Imaging Unit of the San Raffaele Scientific Institute in Milan, Italy, Department of Ophthalmology, Hospital Intercommunal de Creteil, University Paris Est in Creteil, France of and Bietti Foundation in Rome, Italy).
Methods
In this multicentric longitudinal study involving 3 retina referral centers, patients previously affected by GA that developed an active MNV were included. Patients were investigated using structural optical coherence tomography (OCT), fundus autofluorescence, OCT-angiography, and dye angiographies. Patients were treated with ProReNata (PRN) anti-vascular endothelial growth factor (VEGF) injections and were revaluated after treatment.
Results
Among 512 patients previously diagnosed with GA, 40 eyes of 40 patients (mean age 80.8±7.9 years, mean GA area 8.73±7.39 mm2) presented with treatment-naïve exudative MNV (accounting for an estimated prevalence of 7.81%; 5.49 - 10.13, 95% confidence intervals) and thus were included in the analysis. 67.5% of MNVs were classified as type 2 MNV, 25% as type 1, 2.5% as type 3, and 5% as mixed phenotype. In 92.5% of cases, active MNV in GA showed subretinal hyperreflective material (SHRM) with or without evidence of sub-/intra-retinal hyporeflective exudation. During a mean follow-up of 2825 months, patients were treated with 6.66.3 anti-VEGF injections, with 2.91.4 injections in the first year of treatment. No patient developed GA enlargement in the area of MNV.
Conlusions
MNVs in GA showed different features and therapeutic response in comparison to previously reported features of MNV in age-related macular degeneration (AMD) without GA. For these reasons, the combined phenotype (i.e. GA with neovascular AMD) should be considered as a distinct entity in the research and clinical setting.
Financial Disclosure
none
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