OBJECTIVE: To assess the frequency of lesion types using fluorescein angiography (FA) in neovascular age-related macular degeneration (nAMD). DESIGN: Cross-sectional study. PARTICIPANTS: Two hundred cases of nAMD. METHODS: Fluorescein angiograms from 908 patients (university-based, tertiary retinal referral practice [UP] = 478; comprehensive, community-based eye clinic [CC] = 430) were reviewed to identify 200 cases of nAMD (100 from each center). Two graders evaluated the frequency of angiographic subtypes. MAIN OUTCOME MEASURES: Identifying (1) the frequency of subfoveal nAMD lesions that meet the definition of "predominantly classic," "minimally classic," "occult with no classic"; (2) lesion location, size, and subtype; and (3) the intergrader agreement (kappa). RESULTS: There was little difference in the frequency of lesion type between the UP and the CC. Most nAMD lesions were subfoveal (78.5%, 157 of 200), and of these, 20% (32 of 157) were predominantly classic; whereas 73% (114 of 157) were occult with no classic, and 7% (11 of 157) were minimally classic. Of the 200 angiograms, 33 (16.5%) were juxtafoveal, and 10 (5%) were extrafoveal. Twenty of the 43 juxtafoveal and extrafoveal lesions (47%) were predominantly classic. Classic with no occult subfoveal lesions were smaller than minimally classic or occult with no classic (1.7 vs. 3.7 and 2.8 mm; P = 0.001 and 0.01, respectively). Of 114 subfoveal occult with no classic lesions, 54 (47%) had both smaller lesion size <==4 disc areas (DA) and lower visual acuity <20/50, whereas 107 (94%) had a smaller lesion or lower visual acuity. CONCLUSIONS: Most angiographic lesions of patients who undergo FA for nAMD are subfoveal and occult. We estimate that 20% of subfoveal lesions are predominantly classic. Approximately half of the juxtafoveal and extrafoveal lesions are predominantly classic. Nearly 30% of all nAMD lesions have both small occult lesions (size <==4 DA) and a visual acuity less than 20/50. We found minimal difference in lesion type between a UP and a CC.
OBJECTIVE: To assess the frequency of lesion types using fluorescein angiography (FA) in neovascular age-related macular degeneration (nAMD). DESIGN: Cross-sectional study. PARTICIPANTS: Two hundred cases of nAMD. METHODS:Fluorescein angiograms from 908 patients (university-based, tertiary retinal referral practice [UP] = 478; comprehensive, community-based eye clinic [CC] = 430) were reviewed to identify 200 cases of nAMD (100 from each center). Two graders evaluated the frequency of angiographic subtypes. MAIN OUTCOME MEASURES: Identifying (1) the frequency of subfoveal nAMD lesions that meet the definition of "predominantly classic," "minimally classic," "occult with no classic"; (2) lesion location, size, and subtype; and (3) the intergrader agreement (kappa). RESULTS: There was little difference in the frequency of lesion type between the UP and the CC. Most nAMD lesions were subfoveal (78.5%, 157 of 200), and of these, 20% (32 of 157) were predominantly classic; whereas 73% (114 of 157) were occult with no classic, and 7% (11 of 157) were minimally classic. Of the 200 angiograms, 33 (16.5%) were juxtafoveal, and 10 (5%) were extrafoveal. Twenty of the 43 juxtafoveal and extrafoveal lesions (47%) were predominantly classic. Classic with no occult subfoveal lesions were smaller than minimally classic or occult with no classic (1.7 vs. 3.7 and 2.8 mm; P = 0.001 and 0.01, respectively). Of 114 subfoveal occult with no classic lesions, 54 (47%) had both smaller lesion size <==4 disc areas (DA) and lower visual acuity <20/50, whereas 107 (94%) had a smaller lesion or lower visual acuity. CONCLUSIONS: Most angiographic lesions of patients who undergo FA for nAMD are subfoveal and occult. We estimate that 20% of subfoveal lesions are predominantly classic. Approximately half of the juxtafoveal and extrafoveal lesions are predominantly classic. Nearly 30% of all nAMD lesions have both small occult lesions (size <==4 DA) and a visual acuity less than 20/50. We found minimal difference in lesion type between a UP and a CC.
Authors: S Y Cohen; C Creuzot-Garcher; J Darmon; T Desmettre; J F Korobelnik; F Levrat; G Quentel; S Paliès; A Sanchez; A Solesse de Gendre; H Schluep; M Weber; C Delcourt Journal: Br J Ophthalmol Date: 2007-03-23 Impact factor: 4.638
Authors: Susanna S Park; Steven N Truong; Robert J Zawadzki; Suhail Alam; Stacey S Choi; David G Telander; John S Werner; Lawrence S Morse Journal: Invest Ophthalmol Vis Sci Date: 2010-03-10 Impact factor: 4.799
Authors: Gregory R Jackson; Ingrid U Scott; Ivana K Kim; David A Quillen; Alessandro Iannaccone; John G Edwards Journal: Invest Ophthalmol Vis Sci Date: 2014-03-10 Impact factor: 4.799
Authors: John S Wittenborn; Traci Clemons; Carl Regillo; Nadim Rayess; Danielle Liffmann Kruger; David Rein Journal: JAMA Ophthalmol Date: 2017-05-01 Impact factor: 7.389
Authors: Barbara S Hawkins; Neil M Bressler; Päivi H Miskala; Susan B Bressler; Nancy M Holekamp; Marta J Marsh; Maryann Redford; Steven D Schwartz; Paul Sternberg; Matthew A Thomas; David J Wilson Journal: Ophthalmology Date: 2004-11 Impact factor: 12.079