Aaron Nagiel1, David Sarraf, Srinivas R Sadda, Richard F Spaide, Jesse J Jung, Kavita V Bhavsar, Hossein Ameri, Giuseppe Querques, K Bailey Freund. 1. *Division of Retinal Disorders and Ophthalmic Genetics, Stein Eye Institute, Department of Ophthalmology, University of California, Los Angeles Geffen School of Medicine, Los Angeles, California; †Department of Surgery, Greater Los Angeles Veteran's Administration Healthcare Center, Los Angeles, California; ‡Department of Ophthalmology, Kaiser Permanente, Woodland Hills, California; §Doheny Eye Institute, Department of Ophthalmology, University of California, Los Angeles Geffen School of Medicine, Los Angeles, California; ¶University of Southern California Eye Institute, Department of Ophthalmology, Keck School of Medicine, Los Angeles, California; **Vitreous-Retina-Macula Consultants of New York and LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear, and Throat Hospital, New York, New York; ††Department of Ophthalmology, New York University School of Medicine, New York, New York; ‡‡Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia College of Physicians and Surgeons, New York, New York; and §§Department of Ophthalmology, University Paris XII, Center Intercommunal de Creteil, Creteil, France.
Abstract
PURPOSE: To demonstrate the evolution and treatment response of Type 3 neovascularization using spectral domain optical coherence tomography. METHODS: We retrospectively analyzed 40 eyes treated with intravitreal anti-vascular endothelial growth factor therapy for Type 3 neovascularization over a variable follow-up period. RESULTS: In 17 eyes, spectral domain optical coherence tomography captured the development of Type 3 neovascularization from punctate hyperreflective foci that preceded any outer retinal defect. The more mature Type 3 lesions were associated with outer retinal disruption and adjacent cystoid macular edema. In addition, 37 of 40 Type 3 lesions (93%) were associated with an underlying pigment epithelial detachment, of which 26 (70%) were drusenoid, 6 (16%) serous, and 5 (14%) mixed. Type 3 vessels appeared to leak fluid into the pigment epithelial detachment cavity, creating serous pigment epithelial detachments as large as 925 μm in maximal height. Treatment with anti-vascular endothelial growth factor agents led to prompt involution of the lesion and resorption of the intraretinal and subretinal pigment epithelium fluid after one or two injections (median = 1). CONCLUSION: In some eyes with age-related macular degeneration, the earliest sign of Type 3 neovascularization is punctate hyperreflective foci above the external limiting membrane. The mature Type 3 lesions and associated serous pigment epithelial detachments are highly responsive to anti-vascular endothelial growth factor therapy.
PURPOSE: To demonstrate the evolution and treatment response of Type 3 neovascularization using spectral domain optical coherence tomography. METHODS: We retrospectively analyzed 40 eyes treated with intravitreal anti-vascular endothelial growth factor therapy for Type 3 neovascularization over a variable follow-up period. RESULTS: In 17 eyes, spectral domain optical coherence tomography captured the development of Type 3 neovascularization from punctate hyperreflective foci that preceded any outer retinal defect. The more mature Type 3 lesions were associated with outer retinal disruption and adjacent cystoid macular edema. In addition, 37 of 40 Type 3 lesions (93%) were associated with an underlying pigment epithelial detachment, of which 26 (70%) were drusenoid, 6 (16%) serous, and 5 (14%) mixed. Type 3 vessels appeared to leak fluid into the pigment epithelial detachment cavity, creating serous pigment epithelial detachments as large as 925 μm in maximal height. Treatment with anti-vascular endothelial growth factor agents led to prompt involution of the lesion and resorption of the intraretinal and subretinal pigment epithelium fluid after one or two injections (median = 1). CONCLUSION: In some eyes with age-related macular degeneration, the earliest sign of Type 3 neovascularization is punctate hyperreflective foci above the external limiting membrane. The mature Type 3 lesions and associated serous pigment epithelial detachments are highly responsive to anti-vascular endothelial growth factor therapy.
Authors: Claudine E Pang; Jeffrey D Messinger; Emma C Zanzottera; K Bailey Freund; Christine A Curcio Journal: Ophthalmology Date: 2015-08-19 Impact factor: 12.079
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Authors: Jin Yang; Qinqin Zhang; Elie H Motulsky; Marie Thulliez; Yingying Shi; Cancan Lyu; Luis de Sisternes; Mary K Durbin; William Feuer; Ruikang K Wang; Giovanni Gregori; Philip J Rosenfeld Journal: Am J Ophthalmol Date: 2019-06-21 Impact factor: 5.258