Analysis of clinical features of choroidal neovascularization

Abstract

To investigate the clinical features of choroidal neovascularization (CNV) in different classifications. In this retrospective case series, 393 eyes of 312 patients with CNV between May 2005 and March 2007 in our department was classified based on their etiology, location, fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) findings. The relative frequency of various causes in CNV was as follows: there were 153 cases (49.04%) from age-related macular degeneration (AMD) , 94 cases (30.13%) from idiopathic CNV, 37 cases (11.86%) from pathologic myopia, 15 cases (4.81%) from inflammatory disorders, 7 cases (2.24%) from polypoidal choroidal vasculopathy (PCV), 3 cases (0.96%) from angioid streaks and 1 case (0.32%) from either hereditary disease or trauma or tumor, respectively. The majority cases from AMD was male (64.71%), whereas most from pathologic myopia, idiopathic CNV and inflammatory disorders were female (78.38%, 73.40%, 73.33%). The age range of the cases from AMD was 49-95 years (68.73 +/- 8.31), and 98.04% of them were at least 50 years old. Patients with idiopathic CNV aged 13-43 years old (29.86 +/- 6.45), and 84.04% of them were between 20 and 40 years old. The sex (chi2 = 57.17, P<0.05) and age (F=172.57, P< 0.05) had significant difference in each etiological group. FFA showed that CNV in 43.48% from AMD and 66.67% from PCV were occult and non-classic. CNV in 91.67% from pathologic myopia, 76.19% from inflammatory disorders and 95.00% from idiopathic CNV was classic. In each group, most of the CNV was subfoveal type (58.00%-100.00%), followed by juxtafoveal type (0%-35.00%). In the ICGA of 54 eyes with AMD, 11 eyes (20.37%) were occult CNV (plaque, spot and mixed CNV), 17 eyes (31.48%) were CNV fibrosis. CNV was active in most cases. The frequency of active and inactive CNV in AMD was approximately 61.11% and 37.04%, respectively, no lesions were noted in 1 eye (1.85%) in ICGA. The clinical characteristics and frequency of various types of CNV are different due to different causes. Classification of CNV based on its etiology, FFA and ICGA findings, location, and activity in detail is important for the diagnosis, treatment and prognosis judgment in CNV.