ROY W.BECKMD, PhD
To describe incident choroidal neovascular lesions in fellow eyes of participants in the Submacular Surgery Trials who had age-related macular degeneration (AMD).
Review of baseline fluorescein angiograms confirmed the absence of neovascular AMD in fellow eyes of 364 participants at risk. Subjects were eligible for a minimum of 2 years of follow-up with angiograms of eyes at risk reevaluated to estimate incidence rates of choroidal neovascularization (CNV) and to characterize these lesions.
Main Outcome Measures
Incidence of CNV during follow-up, characteristics of the incident lesion (composition, size, and location), and visual acuity at the time of incidence.
Incident lesions were confirmed in 98 fellow eyes of participants, yielding 2- and 4-year cumulative incidence rates of 22% and 37%. Incident lesions were predominantly CNV in 87 fellow eyes (90%), extrafoveal in 29 fellow eyes (30%), and juxtafoveal in 9 fellow eyes (9%). Occult without classic CNV lesions were found in 64 eyes (67%), minimally classic CNV and predominantly classic CNV lesions in 12 eyes (13%) each, and predominantly blood lesions in 4 eyes (4%). Nearly two-thirds of all incident lesions were 3 disc areas or smaller in size. Median visual acuity decreased from 20/25 at baseline to 20/250 at the 4-year follow-up in fellow eyes with incident CNV.
Conclusions and Application to Clinical Practice
Frequent angiographic follow-up of fellow eyes at risk for CNV may lead to earlier detection and treatment of neovascular AMD and better visual acuity outcomes.
clinicaltrials.gov Identifier: LOCATOR="http://clinicaltrials.gov/show/NCT00000150">NCT00000150
Submacular Surgery Trials Research Group*. Incident Choroidal Neovascularization in Fellow Eyes of Patients With Unilateral Subfoveal Choroidal Neovascularization Secondary to Age-Related Macular DegenerationSST Report No. 20 From the Submacular Surgery Trials Research Group. Arch Ophthalmol. 2007;125(10):1323-1330. doi:10.1001/archopht.125.10.1323