Comparison of exudative age-related macular degeneration subtypes in Japanese and French Patients: multicenter diagnosis with multimodal imaging.
OBJECTIVE
To compare and analyze differences and similarities between Japanese and French patients in subtype diagnosis of exudative age-related macular degeneration (AMD) as determined by fundus photography (FP) and fluorescein angiography (FA), and a multimodal imaging involving FP, FA, indocyanine green angiography (ICGA), and optical coherence tomography (OCT).


METHODS
Retrospective chart review.


METHODS
We determined the subtype diagnosis for 99 consecutive Japanese eyes and 94 consecutive French eyes with exudative AMD. The first-step diagnosis was made using FP and FA, while the second-step diagnosis was made using FP, FA/ICGA, and OCT. The diagnoses made by Japanese and French physicians were compared, and when the diagnoses differed, a third institute was consulted to arrive at a final consensus and diagnosis.


RESULTS
The first-step diagnosis showed 20%-30% disagreement against the final diagnosis, but the second-step diagnosis showed only 10% disagreement. Polypoidal choroidal vasculopathy (PCV) was observed more in Japanese patients (48%) than in French (9%), and the rate of PCV with type 1 or 2 choroidal neovascularization (CNV) was extremely low: 3% in Japanese and 0% in French. Type 1 CNV was found significantly more in French cases (53.3% vs 35.1%, P=.018), while the rate of eyes with type 2 CNV only or chorioretinal anastomosis was similar between populations.


CONCLUSIONS
Multimodality imaging significantly improved the sub-classification of AMD. There were significant differences between the 2 series in the proportions of type 1 CNV and PCV, while the proportions of type 2 CNV only and chorioretinal anastomosis were similar between groups.
Centre d'Ophtalmologie de Paris, Paris, France; Department of Ophthalmology, University Paris-Est Créteil, Paris XII, Creteil, France. Electronic address: gabriel.coscas@gmail.com.
Gabriel
G
Coscas
Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Kenji
K
Yamashiro
Centre d'Ophtalmologie de Paris, Paris, France; Department of Ophthalmology, University Paris-Est Créteil, Paris XII, Creteil, France.
Florence
F
Coscas
Centre d'Ophtalmologie de Paris, Paris, France; Department of Ophthalmology, University Paris-Est Créteil, Paris XII, Creteil, France.
Umberto
U
De Benedetto
Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Akitaka
A
Tsujikawa
Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Masahiro
M
Miyake
Singapore Eye Research Institute, Singapore National Eye Centre, National University of Singapore, Singapore.
Chui Ming
CM
Gemmy Cheung
Singapore Eye Research Institute, Singapore National Eye Centre, National University of Singapore, Singapore.
Tien Yin
TY
Wong
Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Nagahisa
N
Yoshimura
D000368:Aged; D003937:Diagnosis, Differential; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D005654:Fundus Oculi; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D064847:Multimodal Imaging / Q000379:methods*; D015203:Reproducibility of Results; D012171:Retinal Vessels / Q000473:pathology*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D041623:Tomography, Optical Coherence; D014792:Visual Acuity; D057135:Wet Macular Degeneration / Q000175:diagnosis* / Q000453:epidemiology