The incidence of neovascular subtypes in newly diagnosed neovascular age-related macular degeneration

Jesse J Jung, Christine Y Chen, Sarah Mrejen, Roberto Gallego-Pinazo, Luna Xu, Marcela Marsiglia, Sucharita Boddu, K Bailey Freund

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96 Citations (Scopus)


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). Retrospective cohort. 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. 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 ? statistic was 0.65 (standard error ?0.37, P <.001) between the 2 classification systems, representing good agreement. 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 ? 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. Copyright ? 2014 Elsevier Inc. All rights reserved.
Original languageEnglish
Pages (from-to)769 - 779
Number of pages11
JournalAmerican Journal of Ophthalmology
Issue number4 (Art. ID: e2)
Publication statusPublished - 2014

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