Abstract
To determine the prevalence of subclinical nonexudative neovascularization and associated choroidal vascular changes in the fellow eyes of patients presenting with unilateral typical exudative AMD (tAMD) or polypoidal choroidal vasculopathy (PCV) using indocyanine green angiography (ICGA) and swept-source (SS) optical coherence tomography angiography (OCT-A). We recruited patients presenting with tAMD or PCV in a prospective clinical study. The diagnosis in the presenting eye was determined based on clinical, fluorescein angiography (FA), and ICGA findings. We evaluated the contralateral eye for presence of nonexudative neovascularization, choroidal hyperpermeability, and pachyvessels in the outer choroid, based on multimodal imaging which included ICGA, spectral-domain (SD) OCT and OCT-A. We measured subfoveal choroidal thickness in both eyes for each patient. We included 76 fellow eyes of 76 patients who presented with unilateral tAMD (n = 33) or PCV (n = 43). Nonexudative neovascularization was present in 18% eyes (14 eyes, 8 in tAMD group, 6 in PCV group; 7 on ICGA, 4 on OCT-A, 3 on both ICGA and OCT-A). Pachychoroid pigment epitheliopathy was present in 13 eyes with nonexudative neovascularization, and was the only risk factor associated with nonexudative neovascularization. Approximately one in five fellow eyes with unilateral tAMD and PCV have features of nonexudative neovascularization. The use of multimodal imaging including ICGA and OCT-A can identify these features. The presence of pachychoroid epitheliopathy should alert clinicians to the possibility of underlying neovascularization.
Highlights
We included 76 fellow eyes of 76 patients who presented with unilateral typical exudative AMD (tAMD) (n 1⁄4 33) or polypoidal choroidal vasculopathy (PCV) (n 1⁄4 43)
To determine the prevalence of subclinical nonexudative neovascularization and associated choroidal vascular changes in the fellow eyes of patients presenting with unilateral typical exudative AMD or polypoidal choroidal vasculopathy (PCV) using indocyanine green angiography (ICGA) and swept-source (SS) optical coherence tomography angiography (OCT-A)
Nonexudative neovascularization was present in 18% eyes (14 eyes, 8 in tAMD group, 6 in PCV group; 7 on ICGA, 4 on OCT-A, 3 on both ICGA and OCT-A)
Summary
We recruited patients presenting with tAMD or PCV in a prospective clinical study. The diagnosis in the presenting eye was determined based on clinical, fluorescein angiography (FA), and ICGA findings. We measured subfoveal choroidal thickness in both eyes for each patient. Data for this study was taken from a prospective, observational cohort study involving patients with exudative AMD in the Asian AMD Phenotyping Study.[21] Detailed methodology has been published elsewhere.[22,23,24] The study was approved by the Singhealth Centralized institutional review board and was conducted according to the tenets of the Declaration of Helsinki. The data for this study was taken from patients recruited between October 2015 and March 2016 at the Singapore National Eye Centre
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