Author: Bilal Haj Najeeb (Austria)
Co-authors: Gabor Deak, Stefan Sacu, Ursula Schmidt-Erfurth, Bianca Gerendas
To report on the morphological characteristics and regional distribution of multifocal macular neovascularization type 3 (mMNV3).
22 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.
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. 15 (68%), 2 (9%) and 16 (73%) eyes were associated with retinal hard exudate, sub retinal pigment epithelium exudate and intraretinal hemorrhage, respectively. 30 (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 500µm, 49 (96%) between 500 and 1500µm and one (2%) between 1500 and 3000µm. 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.
The multifocal variant of MNV3 has specific morphological and topographical characteristics. Multimodal imaging allows to understand the pathomorphological condition in more detail.
BHN: Retinsight, unrelated to this study. GD: none. SS: Roche, Novartis, Bayer all unrelated to this study, USE: Bayer/Novartis/Boehringer-Ingelheim/Alcon/Kinarus, all unrelated to this study. BG: Novartis/Kinarus/IDx, all unrelated to this study.