Types of choroidal neovascularisation in newly diagnosed exudative age-related macular degeneration.
OBJECTIVE
To describe the types and location of choroidal neovascularisation (CNV) in exudative age-related macular degeneration (AMD), including vascularised pigment epithelial detatchments (PED), and most recently described subtypes, such as retinal choroidal anasmostosis, also termed "retinal angiomatous proliferation" (RAP).


METHODS
Prospective multicentre consecutive descriptive case series. A total of 207 consecutive cases of newly diagnosed exudative AMD undergoing fluorescein angiography (FA) were recruited by 7 French referral hospital-based or private centres. Indocyanine green angiography (ICG) also was performed, when judged necessary by investigators. Types and location of CNV were classified by two independent experts and adjudicated by a third when discordant.


RESULTS
All patients had FA, while ICG was performed in 50% of subjects. A total of 17.6% had classic CNV only, 5.4% and 8.3% had predominantly and minimally classic CNV, respectively. Occult CNV could be classified in occult CNV without PED (32.7%) and occult CNV with PED, ie, vascularised PED (23.9%). RAP was observed in 15.1% of cases, and accounted for 30% of vascularised PED. In 5.8% of the cases there was haemorrhagic AMD and 4.8% had fibrovascular scars. Lesions were mainly subfoveal (80%). Agreement between the centre's ophthalmologist and the final validated expert classification was moderate (kappa = 0.52 for location and 0.59 for type of lesion).


CONCLUSIONS
This study confirms that newly diagnosed cases of exudative AMD are mainly occult and subfoveal. RAP appeared as a common lesion in patients with newly diagnosed exudative AMD.
Cohen
S Y
SY
Centre Ophtalmologique d'Imagerie et de Laser, 11 Rue Antoine Bourdelle, 75015 Paris, France. sycohen@club-internet.fr
Creuzot-Garcher
C
C
Darmon
J
J
Desmettre
T
T
Korobelnik
J F
JF
Levrat
F
F
Quentel
G
G
Paliès
S
S
Sanchez
A
A
de Gendre
A Solesse
AS
Schluep
H
H
Weber
M
M
Delcourt
C
C
D000368:Aged; D000369:Aged, 80 and over; D000798:Angiomatosis / Q000209:etiology; D020256:Choroidal Neovascularization / Q000209:etiology / Q000473:pathology*; D005260:Female; D006801:Humans; D008268:Macular Degeneration / Q000150:complications / Q000473:pathology*; D008297:Male; D011446:Prospective Studies; D012163:Retinal Detachment / Q000209:etiology; D012164:Retinal Diseases / Q000209:etiology