Tommaso Bacci1,2, Juliet O Essilfie1,3,4, Belinda C S Leong1,5, K Bailey Freund6,7,8. 1. Vitreous Retina Macula Consultants of New York, 950 Third Ave., New York, NY, 10022, USA. 2. Ophthalmology Unit, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena University Hospital, Siena, Italy. 3. Department of Ophthalmology, New York University, New York, NY, USA. 4. Manhattan Eye, Ear, and Throat Hospital, Lenox Hill Hospital, New York, NY, USA. 5. Retina Associates, Sydney, Australia. 6. Vitreous Retina Macula Consultants of New York, 950 Third Ave., New York, NY, 10022, USA. kbfnyf@aol.com. 7. Department of Ophthalmology, New York University, New York, NY, USA. kbfnyf@aol.com. 8. Manhattan Eye, Ear, and Throat Hospital, Lenox Hill Hospital, New York, NY, USA. kbfnyf@aol.com.
Abstract
PURPOSE: To describe the clinical and multimodal imaging (MMI) features of age-related macular degeneration (AMD) eyes presenting with intraretinal exudation and no evidence of neovascularization or structural alterations of native retinal vessels. METHODS: This was a retrospective review of the MMI and electronic health records for 3 consecutive patients presenting with unilateral exudative non-neovascular age-related macular degeneration. MMI included confocal color fundus photography (CFP), fundus autofluorescence (FAF), fluorescein angiography (FA), spectral domain optical coherence tomography (SD-OCT), swept-source optical coherence tomography angiography (SS-OCTA), and spectral domain optical coherence tomography angiography (SD-OCTA). Dense B-scan OCTA (DB-OCTA) patterns and implemented image post-processing were used to improve spatial resolution in the OCTA analysis and remove projection artifacts. RESULTS: Three eyes of 3 patients (1 male and 2 females, ages 72-87) developed intraretinal fluid (IRF) producing retinal edema during regular follow-up for non-neovascular AMD. FA, SS-OCTA, and DB-OCTA demonstrated no evidence of macular neovascularization or discrete retinal vascular abnormalities that could explain the IRF accumulation. Two eyes received intravitreal anti-VEGF therapy and demonstrated prompt resolution of IRF with periodic recurrences over time. CONCLUSION: Exudative non-neovascular AMD is a novel clinical phenotype characterized by the presence of non-neovascular intraretinal exudation producing macular edema. Differentiating this condition from other manifestations of AMD requires appropriate use of MMI. Further study is needed to assess the clinical impact and optimal management of exudative non-neovascular AMD.
PURPOSE: To describe the clinical and multimodal imaging (MMI) features of age-related macular degeneration (AMD) eyes presenting with intraretinal exudation and no evidence of neovascularization or structural alterations of native retinal vessels. METHODS: This was a retrospective review of the MMI and electronic health records for 3 consecutive patients presenting with unilateral exudative non-neovascular age-related macular degeneration. MMI included confocal color fundus photography (CFP), fundus autofluorescence (FAF), fluorescein angiography (FA), spectral domain optical coherence tomography (SD-OCT), swept-source optical coherence tomography angiography (SS-OCTA), and spectral domain optical coherence tomography angiography (SD-OCTA). Dense B-scan OCTA (DB-OCTA) patterns and implemented image post-processing were used to improve spatial resolution in the OCTA analysis and remove projection artifacts. RESULTS: Three eyes of 3 patients (1 male and 2 females, ages 72-87) developed intraretinal fluid (IRF) producing retinal edema during regular follow-up for non-neovascular AMD. FA, SS-OCTA, and DB-OCTA demonstrated no evidence of macular neovascularization or discrete retinal vascular abnormalities that could explain the IRF accumulation. Two eyes received intravitreal anti-VEGF therapy and demonstrated prompt resolution of IRF with periodic recurrences over time. CONCLUSION: Exudative non-neovascular AMD is a novel clinical phenotype characterized by the presence of non-neovascular intraretinal exudation producing macular edema. Differentiating this condition from other manifestations of AMD requires appropriate use of MMI. Further study is needed to assess the clinical impact and optimal management of exudative non-neovascular AMD.
Authors: Riccardo Sacconi; Enrico Borrelli; SriniVas Sadda; Giulia Corradetti; K Bailey Freund; Lawrence A Yannuzzi; Eric Souied; Vittorio Capuano; David Sarraf; Lea Querques; Francesco Bandello; Giuseppe Querques Journal: Am J Ophthalmol Date: 2020-04-28 Impact factor: 5.258
Authors: Riccardo Sacconi; K Bailey Freund; Lawrence A Yannuzzi; Rosa Dolz-Marco; Eric Souied; Vittorio Capuano; Oudy Semoun; Nopasak Phasukkijwatana; David Sarraf; Adriano Carnevali; Lea Querques; Francesco Bandello; Giuseppe Querques Journal: Am J Ophthalmol Date: 2017-10-27 Impact factor: 5.258
Authors: Richard F Spaide; Glenn J Jaffe; David Sarraf; K Bailey Freund; Srinivas R Sadda; Giovanni Staurenghi; Nadia K Waheed; Usha Chakravarthy; Philip J Rosenfeld; Frank G Holz; Eric H Souied; Salomon Y Cohen; Giuseppe Querques; Kyoko Ohno-Matsui; David Boyer; Alain Gaudric; Barbara Blodi; Caroline R Baumal; Xiaoxin Li; Gabriel J Coscas; Alexander Brucker; Lawrence Singerman; Phil Luthert; Steffen Schmitz-Valckenberg; Ursula Schmidt-Erfurth; Hans E Grossniklaus; David J Wilson; Robyn Guymer; Lawrence A Yannuzzi; Emily Y Chew; Karl Csaky; Jordi M Monés; Daniel Pauleikhoff; Ramin Tadayoni; James Fujimoto Journal: Ophthalmology Date: 2019-11-14 Impact factor: 12.079