Visual prognosis of second eyes in patients with unilateral late exudative age-related macular degeneration.
OBJECTIVE
A prospective longitudinal study was initiated to analyze the correlation between the prognosis for the second eyes of patients with unilateral late exudative AMD and the disease phenotype.


METHODS
Of the187 patients with unilateral late exudative AMD recruited, 130 (69.5%) had predominantly classic CNV without pigment epithelium detachment (PED) (CNV group), and 57 (30.5%) had occult CNV with serous PED (PED group). Patients were reexamined by ophthalmoscopy and angiography every 6 months for up to 80 months. The end point was ETDRS visual acuity change of 3 lines or more due to late AMD in the second eye.


RESULTS
During follow-up 53 (28.3%) patients reached the end point: 32 (24.6%) in the CNV group and 21 (36.8%) in the PED group. The major prognostic factor for the risk of visual loss in the second eye was the type of late AMD in the first eye (CNV group 6-7% per year, PED group 15-16% per year ( P<0.001). There was significant symmetry between the new exudative lesion in the second eye and that in the first, and significant differences in the density and fluorescence of drusen in the second eye between the two groups.


CONCLUSIONS
Patients with occult CNV with serous PED in the first eye have a significantly higher risk of visual loss in the second eye than patients with CNV without PED. This distinction may be important for future clinical studies. In addition, segregation of AMD by phenotype is necessary in the analysis of genes conferring risk of AMD.
Department of Ophthalmology, St. Franziskus Hospital, Hohenzollernring 74, 48145 Münster, Germany. dapauleikhoff@muenster.de.
Daniel
D
Pauleikhoff
Martin
M
Radermacher
Georg
G
Spital
Christian
C
Müller
Gabriele
G
Brumm
Albrecht
A
Lommatzsch
Alan C
AC
Bird
D000368:Aged; D000369:Aged, 80 and over; D020256:Choroidal Neovascularization / Q000209:etiology / Q000503:physiopathology; D005122:Exudates and Transudates; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008268:Macular Degeneration / Q000150:complications / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D014786:Vision Disorders / Q000209:etiology / Q000503:physiopathology*; D014792:Visual Acuity / Q000502:physiology*