title: Incident choroidal neovascularization in fellow eyes of patients with unilateral subfoveal choroidal neovascularization secondary to age-related macular degeneration: SST report No. 20 from the Submacular Surgery Trials Research Group.
abstract: OBJECTIVE
  To describe incident choroidal neovascular lesions in fellow eyes of participants in the Submacular Surgery Trials who had age-related macular degeneration (AMD).
  
  
  METHODS
  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.
  
  
  METHODS
  Incidence of CNV during follow-up, characteristics of the incident lesion (composition, size, and location), and visual acuity at the time of incidence.
  
  
  RESULTS
  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.
authors.affiliation: Johns Hopkins University School of Medicine, 550 N Broadway, Ste 115, Baltimore, MD 21205-2005, USA. nmboffice@jhmi.edu
authors.forename: Sharon D
authors.initials: SD
authors.lastname: Solomon
authors.forename: Joan L
authors.initials: JL
authors.lastname: Jefferys
authors.forename: Barbara S
authors.initials: BS
authors.lastname: Hawkins
authors.forename: Neil M
authors.initials: NM
authors.lastname: Bressler
mesh_terms: D000368:Aged; D020256:Choroidal Neovascularization / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D005584:Fovea Centralis; D006801:Humans; D015994:Incidence; D008268:Macular Degeneration / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D014792:Visual Acuity / Q000502:physiology