Abstract
The aim of the present study was to investigate the pathomorphological and functional variations of choroidal neovascularization (CNV) in age-related macular degeneration (AMD) in a Chinese population using optical coherence tomography (OCT). This population-based study enrolled 59 patients (age, >45 years; eyes, 70) with early and intermediate-stage AMD from Youyi Road Community, Baoshan District, Shanghai, China. Comprehensive standardized ophthalmic examinations included visual acuity, anterior segment analysis using a slit lamp, dilated fundus evaluation by direct ophthalmoscopy, 90D handheld lens analysis, fundus photography, fundus fluorescein angiography (FFA) and fast optic disk scans using OCT. The macular CNV characteristic profiles in early and intermediate-stage AMD were determined by OCT. Data were obtained on the first visit and the follow-up period ranged between 6 and 24 months, where FFA and OCT outcomes of early and intermediate-stage AMD patients were analyzed. Three profiles of early and intermediate-stage AMD were created from the OCT and FFA results, each with a different prognosis. Firstly, drusens with unclear boundaries and evident pigment proliferation, as well as hypofluorescence around the drusens, was observed via FFA. A slight small arch field located in the retinal pigment epithelium (RPE)/choriocapillary layer (CCL) was shown on OCT scans, indicating exudative AMD. Secondly, RPE detachments of >1 pupillary distance, without CNV in the macular area, indicated geographic chorioretinitis atrophy. Finally, drusens with clear boundaries and few pigment proliferations and no certain surrounding fluorescence was observed via FFA, while a clear RPE/CCL band on the OCT scans indicated slow progress. The results of the present study demonstrated that combined OCT and FFA was the most efficient method for identifying CNV and diagnosing AMD. If the two techniques are not available concurrently, then OCT is a safer and more reliable technique to follow-up early and intermediate-stage AMD patients.
Highlights
Age‐related macular degeneration (AMD) is a disease of the ocular fundus characterized by the degeneration of the choroidal capillaries, retinal pigment epithelium (RPE) and neural retina
An epidemiological survey of AMD in Youyi Road Community, Baoshan District, Shanghai, China was performed between April 2005 and June 2005
The natural course of AMD was satisfactorily observed and recorded using optical coherence tomography (OCT) combined with fundus fluorescein angiography (FFA)
Summary
Age‐related macular degeneration (AMD) is a disease of the ocular fundus characterized by the degeneration of the choroidal capillaries, retinal pigment epithelium (RPE) and neural retina. AMD is the leading cause of blindness in older adults (>50 years‐old) in Western countries [1]. AMD may be classified into dry and wet forms by physicians. The dry form, or central geographic atrophy, accounts for 15‐20% of AMD cases, where vision loss is caused by the loss of photoreceptors. Wet AMD, known as neovascular or exudative AMD, results from choroidal neovascularization (CNV) and affects 80‐85% of those with AMD. The wet form causes the more severe loss of vision. In the natural course of the disease, 10‐20% of dry AMD cases become wet AMD cases, and 42% of patients with monocular wet AMD develop binocular wet AMD within five years [2]
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