Neovascular Age-Related Macular Degeneration



Neovascular Age-Related Macular Degeneration





SALIENT FEATURES



  • Age-related macular degeneration (AMD) is the most common cause of visual impairment in patients older than of 55 years in industrialized countries.1


  • Neovascular AMD (NVAMD) is characterized by growth of abnormal blood vessels (neovascularization) originating from the choroid or retina, leading to hemorrhage, exudation, and subretinal scarring and subsequent vision loss.


  • The historical gold standard for initial diagnosis of choroidal neovascularization (CNV) in NVAMD is fluorescein angiography (FA). CNV may be classified as classic or occult based on the fluorescence pattern.



    • Classic CNV shows an early well-demarcated area of hyperfluorescence that progressively increases in size and intensity.


    • Occult CNV shows a mid-phase or late-phase speckled hyperfluorescence with or without progressive leakage.


  • However, optical coherence tomography (OCT) has become the most common test for diagnosing NVAMD and associated exudation with optical coherence tomography angiography (OCTA) also increasing in popularity for identifying neovascularization.


  • An OCT-based CNV classification system has also been described.



    • Type 1: new vessel growth from under the retinal pigment epithelium (RPE).


    • Type 2: new vessel proliferation between the RPE and neurosensory retina.


    • Type 3: new vessel proliferation originating from within the retina with anastomoses with choroidal circulation (also known as retinal angiomatous proliferation [RAP]).



OCT IMAGING

May 10, 2021 | Posted by in OPHTHALMOLOGY | Comments Off on Neovascular Age-Related Macular Degeneration
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