PREVALENCE OF PATIENTS PRESENTING WITH NEOVASCULAR AGE-RELATED MACULAR DEGENERATION IN AN URBAN POPULATION

Abstract

To determine the number and type of new cases of neovascular age-related macular degeneration (AMD) present in a defined urban population and to establish the proportion that would be recommended for treatment with verteporfin or laser photocoagulation. Patients referred to an ophthalmic center in Vienna during a 10-week period because of recent deterioration in vision caused by newly diagnosed neovascular AMD were included. Neovascular AMD was diagnosed in 168 eyes in 153 patients. One hundred one eyes (60.1%) had lesions that were occult with no classic choroidal neovascularization (CNV); of these, 70 were subfoveal, 19 were juxtafoveal, and 12 were extrafoveal. Thirty-five eyes (20.8%) had predominantly classic lesions; of these, 27 were subfoveal, 6 were juxtafoveal, and 2 were extrafoveal. Thirty-two eyes (19.0%) had minimally classic lesions, of which 31 were subfoveal and 1 was extrafoveal. In accordance with consensus guidelines from a panel of experts and with American Academy of Ophthalmology's Preferred Practice Pattern guidelines, 33 lesions (17%) would be considered for treatment with verteporfin therapy. A further 37 subfoveal lesions with occult with no classic CNV and 7 juxtafoveal lesions with occult with no classic CNV might also benefit from verteporfin therapy if there is evidence of presumed recent disease progression. Five lesions (3.0%) could have been treated with laser photocoagulation according to Macular Photocoagulation Study criteria. These results suggest that verteporfin therapy substantially increases the number of patients with treatable neovascular AMD.