Abstract
BackgroundType 2 macular neovascularization (MNV) is supposed to be a rare condition in age-related macular degeneration (AMD). The main purpose of this study was to assess accompanying factors of type 2 MNV in AMD.MethodsRetrospective data analysis of eyes previously diagnosed with neovascular AMD in a tertiary eye care center (Medical Retina Unit, Rudolf Foundation Hospital, Vienna, Austria) between June 2008 and December 2017. Drusen subtypes, fibrosis, atrophy and subfoveal choroidal thickness (SFCT) of both eyes in patients with type 2 MNV lesions were categorized based on multimodal imaging.ResultsType 2 MNV was diagnosed in 27 (3.2%) of 835 eyes (749 patients). Drusen characteristics in type 2 MNV were observed as followed: drusen < 63 μm in 2 eyes (7.4%), drusen ≥63 μm in 10 eyes (37%), subretinal drusenoid deposits (SDD) in 8 eyes (29.6%), cuticular drusen in 2 eye (7.4%) and no drusen were evident in 10 eyes (37%). Drusen distribution in 23 fellow eyes was detected as followed: drusen < 63 μm in 2 eyes (8.7%), drusen ≥63 μm in 9 eyes (39.1%), SDD in 5 eyes (21.7%), cuticular drusen in 1 eye (4.3%) and no drusen were evident in 9 eyes (39.1%). Mean SFCT was 140 ± 49 μm in affected eyes and 152 ± 41 μm in the fellow eyes. Patients with drusen or SDD were significantly younger (mean 70.88 ± 6.85, p = 0.04) than patients without deposits (mean 77.40 ± 5.74).ConclusionsType 2 MNV remains a rare entity in AMD. It was frequently seen in the absence of drusen, a hallmark of AMD. These findings contribute to the heterogeneity of phenotypes related to pure type 2 lesions.
Highlights
Type 2 macular neovascularization (MNV) is supposed to be a rare condition in age-related macular degeneration (AMD)
The main purpose of this study was to gain a better understanding of the characteristics associated with type 2 MNV in AMD based on multimodal imaging
Consenting patients were initially diagnosed and classified into anatomic subtypes of neovascular lesions based on fundus examination by slit-lamp biomicroscopy (Haag- Streit AG, Bern, Switzerland) and multimodal imaging including nearinfrared fundus reflectance (IR), blue-peak fundus autofluorescence (BAF) images, spectral-domain (SD) optical coherence tomography (OCT), high resolution fluorescein angiography (FA) and indocyanine green angiography (ICGA)
Summary
Type 2 macular neovascularization (MNV) is supposed to be a rare condition in age-related macular degeneration (AMD). And intermediate age-related macular degeneration (AMD) are defined by the existence of drusen, pigmentary abnormalities or extrafoveal atrophy [1, 2]. Ahmed et al BMC Ophthalmology (2020) 20:381 term macular neovascularization (MNV) more adequate to sum up all neovascular entities in AMD including type 3 [8, 9]. Type 1 MNV originates from the choroid and remains exclusively underneath the RPE. Polypoidal choroidal vasculopathy has recently been described as aneurysmal neovascularization type 1 and represents a subtype of this entity [10]. A mixed type neovascularization is composed of new choroidal vessels growing in more than one layer. Type 3 neovascularization called retinal angiomatous proliferation (RAP) - reflects a distinct form of nAMD with an intraretinal origin and different pathophysiology [11]
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