Abstract
To evaluate the incidence and risk factors of neovascularization in unaffected fellow eyes of patients diagnosed with type 3 neovascularization in Korea. This retrospective study included 93 unaffected fellow eyes of 93 patients diagnosed with type 3 neovascularization. For initial type 3 neovascularization diagnosis, optical coherence tomography and angiography were conducted. These baseline data were compared between patients with and without neovascularization in their fellow eyes during the follow-up period. The mean follow-up period was 66.1±31.1 months. Neovascularization developed in 49 (52.8%) fellow eyes after a mean period of 29.5±19.6 months. In the fellow eye neovascularization group, the incidence of soft drusen and reticular pseudodrusen was significantly higher than that in the non-neovascularization group (83.7% vs. 36.5%, p<0.001; 67.3% vs. 40.9%, p = 0.017, respectively), but the choroidal vascularity index (CVI) showed a significantly lower value (60.7±2.0% vs. 61.7±2.5%; p = 0.047). The presence of reticular pseudodrusen was related with the duration from baseline to development of fellow eye neovascularization (p = 0.038). Neovascularization developed in 52.8% of unaffected fellow eyes. The presence of soft drusen, reticular pseudodrusen, and lower CVI values can be considered risk factors of neovascularization in unaffected fellow eyes of patients with type 3 neovascularization. The lower CVI values suggest that choroidal ischemic change may affect the development of choroidal neovascularization in these patients.
Highlights
Retinal angiomatous proliferation (RAP) is a type of neovascular age-related macular degeneration
The presence of reticular pseudodrusen was related with the duration from baseline to development of fellow eye neovascularization (p = 0.038)
The lower choroidal vascularity index (CVI) values suggest that choroidal ischemic change may affect the development of choroidal neovascularization in these patients
Summary
Retinal angiomatous proliferation (RAP) is a type of neovascular age-related macular degeneration (nAMD). Chang et al [13] reported an incidence of 38.3% of unaffected fellow eye neovascularization in patients with type 3 neovascularization during mean 27.8-month follow-up. These inconsistencies in the reported results could be due to variation in reporting baseline characteristics and follow-up period among studies. All these studies indicate a high risk of unaffected fellow eye involvement in patients with type 3 neovascularization. Identifying the risk factors for fellow eye neovascularization is crucial for preventing bilateral poor visual outcomes in these patients
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