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The Incidence of Neovascular Subtypes in Newly Diagnosed Neovascular Age-Related Macular Degeneration

American journal of ophthalmology, 2014-10, Vol.158 (4), p.769-779.e2 [Peer Reviewed Journal]

Elsevier Inc. ;2014 Elsevier Inc. ;Copyright © 2014 Elsevier Inc. All rights reserved. ;Copyright Elsevier Limited Oct 2014 ;ISSN: 0002-9394 ;EISSN: 1879-1891 ;DOI: 10.1016/j.ajo.2014.07.006 ;PMID: 25034111 ;CODEN: AJOPAA

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Title:
The Incidence of Neovascular Subtypes in Newly Diagnosed Neovascular Age-Related Macular Degeneration
Author: Jung, Jesse J ; Chen, Christine Y ; Mrejen, Sarah ; Gallego-Pinazo, Roberto ; Xu, Luna ; Marsiglia, Marcela ; Boddu, Sucharita ; Freund, K. Bailey
Subjects: Aged, 80 and over ; Angiogenesis Inhibitors - therapeutic use ; Choroidal Neovascularization - classification ; Classification ; Confidence intervals ; Diabetes ; Diabetic retinopathy ; Female ; Fluorescein Angiography ; Glaucoma ; Health Insurance Portability & Accountability Act 1996-US ; Humans ; Hypertension ; Incidence ; Macular degeneration ; Male ; Medical imaging ; Occult sciences ; Older people ; Ophthalmology ; Retrospective Studies ; Tomography ; Tomography, Optical Coherence ; Vascular endothelial growth factor ; Vascular Endothelial Growth Factor A - antagonists & inhibitors ; Visual Acuity ; Wet Macular Degeneration - classification ; Wet Macular Degeneration - diagnosis ; Wet Macular Degeneration - drug therapy
Is Part Of: American journal of ophthalmology, 2014-10, Vol.158 (4), p.769-779.e2
Description: Purpose To determine the frequency of neovascularization subtypes as determined by fluorescein angiography (FA) alone vs FA and optical coherence tomography (OCT) grading in age-related macular degeneration (AMD). Design Retrospective cohort. Methods participants : Newly diagnosed neovascular AMD patients who initiated intravitreal anti–vascular endothelial growth factor therapy by 1 physician from October 1, 2005 to December 1, 2012. interventions : Two independent graders classified the baseline lesions using FA alone and FA+OCT. main outcome measures : Analysis of the frequency of lesion subtypes by FA alone or FA+OCT and agreement between both classification systems was performed. Results A total of 232 patients (266 eyes) fit the inclusion criteria. Mean age was 86.3 years; 67.7% of eyes (180/266) were from female patients, and 95.5% (254/266) were from white patients. The distribution using FA alone was 49.6% (132/266), 12.0% (32/266), 28.6% (76/266), and 9.8% (26/266) among occult, classic, retinal angiomatous proliferation, and mixed choroidal neovascularization, respectively. With FA+OCT, 39.9% (106/266), 9.0% (24/266), 34.2% (91/266), and 16.9% (45/266) were type 1 (sub–retinal pigment epithelium), type 2 (subretinal), type 3 (intraretinal), and mixed neovascularization (NV), respectively. The κ statistic was 0.65 (standard error ±0.37, P < .001) between the 2 classification systems, representing good agreement. Conclusion With both FA-alone and FA+OCT grading, we found a higher incidence of type 3 NV in eyes with newly diagnosed neovascular AMD than that reported in prior studies. The κ statistic between the 2 classification systems showed “good” agreement. The discrepancies are likely attributable to the identification of a higher frequency of type 3 and mixed NV and a lower frequency of type 1 NV with the aid of OCT.
Publisher: United States: Elsevier Inc
Language: English
Identifier: ISSN: 0002-9394
EISSN: 1879-1891
DOI: 10.1016/j.ajo.2014.07.006
PMID: 25034111
CODEN: AJOPAA
Source: MEDLINE
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The Incidence of Neovascular Subtypes in Newly Diagnosed Neovascular Age-Related Macular Degeneration

Elsevier Inc. ;2014 Elsevier Inc. ;Copyright © 2014 Elsevier Inc. All rights reserved. ;Copyright Elsevier Limited Oct 2014 ;ISSN: 0002-9394 ;EISSN: 1879-1891 ;DOI: 10.1016/j.ajo.2014.07.006 ;PMID: 25034111 ;CODEN: AJOPAA

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