Association of clinical characteristics with disease subtypes, initial visual acuity, and visual prognosis in neovascular age-related macular degeneration

Abstract

To comprehend the clinical characteristics and factors related to visual prognosis in two major subtypes of neovascular age-related macular degeneration (AMD)-traditional, typical AMD and polypoidal choroidal vasculopathy (PCV). Medical records of 272 eyes of 216 patients diagnosed with neovascular AMD at Kyoto University Hospital between January 2000 and March 2003 were retrospectively reviewed for up to 3 years. Ophthalmoscopic, angiographic, and optical coherence tomography (OCT) findings were collected, and univariate and multivariate analyses were performed to determine the characteristic factors, the factors associated with initial visual acuity (VA), and visual prognosis in typical AMD and PCV. We studied 154 eyes with typical AMD and 117 eyes with PCV. The presence of classic choroidal neovascularization (CNV) and posterior confluent drusen were characteristic of typical AMD, whereas PCV was characterized by a larger number of retinal pigment epithelial detachments and a small number of drusen. Poor initial VA (<0.1) was significantly associated with subfoveal classic CNV, hard exudates, late fibrosis staining of >or =1 disc area in AMD, and with blood and cystoid macular edema in PCV. Maintenance of good VA was associated with better initial VA in typical AMD and with smaller lesions in PCV. Typical AMD and PCV revealed statistical differences both in their clinical characteristics and in the factors associated with visual prognosis.