title: The incidence of neovascular subtypes in newly diagnosed neovascular age-related macular degeneration.
abstract: OBJECTIVE
  To determine the frequency of neovascularization subtypes as determined by fluorescein angiography (FA) alone vs FA and optical coherence tomography (OCT) grading in age-related macular degeneration (AMD).
  
  
  METHODS
  Retrospective cohort.
  
  
  METHODS
  participants: Newly diagnosed neovascular AMD patients who initiated intravitreal anti-vascular endothelial growth factor therapy by 1 physician from October 1, 2005 to December 1, 2012. interventions: Two independent graders classified the baseline lesions using FA alone and FA+OCT. main outcome measures: Analysis of the frequency of lesion subtypes by FA alone or FA+OCT and agreement between both classification systems was performed.
  
  
  RESULTS
  A total of 232 patients (266 eyes) fit the inclusion criteria. Mean age was 86.3 years; 67.7% of eyes (180/266) were from female patients, and 95.5% (254/266) were from white patients. The distribution using FA alone was 49.6% (132/266), 12.0% (32/266), 28.6% (76/266), and 9.8% (26/266) among occult, classic, retinal angiomatous proliferation, and mixed choroidal neovascularization, respectively. With FA+OCT, 39.9% (106/266), 9.0% (24/266), 34.2% (91/266), and 16.9% (45/266) were type 1 (sub-retinal pigment epithelium), type 2 (subretinal), type 3 (intraretinal), and mixed neovascularization (NV), respectively. The κ statistic was 0.65 (standard error ±0.37, P < .001) between the 2 classification systems, representing good agreement.
  
  
  CONCLUSIONS
  With both FA-alone and FA+OCT grading, we found a higher incidence of type 3 NV in eyes with newly diagnosed neovascular AMD than that reported in prior studies. The κ statistic between the 2 classification systems showed "good" agreement. The discrepancies are likely attributable to the identification of a higher frequency of type 3 and mixed NV and a lower frequency of type 1 NV with the aid of OCT.
authors.affiliation: Department of Ophthalmology, New York University School of Medicine, New York, New York; Vitreous Retina Macula Consultants of New York, New York, New York; LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear and Throat Hospital, New York, New York; Edward S. Harkness Eye Institute, Columbia University College of Physicians and Surgeons, New York, New York.
authors.forename: Jesse J
authors.initials: JJ
authors.lastname: Jung
authors.affiliation: Vitreous Retina Macula Consultants of New York, New York, New York; LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear and Throat Hospital, New York, New York; Department of Surgery, Monash University, Melbourne, Australia; Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia.
authors.forename: Christine Y
authors.initials: CY
authors.lastname: Chen
authors.affiliation: Vitreous Retina Macula Consultants of New York, New York, New York; LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear and Throat Hospital, New York, New York.
authors.forename: Sarah
authors.initials: S
authors.lastname: Mrejen
authors.affiliation: Vitreous Retina Macula Consultants of New York, New York, New York; Department of Ophthalmology, University and Polytechnic Hospital La Fe, Valencia, Spain.
authors.forename: Roberto
authors.initials: R
authors.lastname: Gallego-Pinazo
authors.affiliation: The New York Eye and Ear Infirmary, New York, New York.
authors.forename: Luna
authors.initials: L
authors.lastname: Xu
authors.affiliation: Vitreous Retina Macula Consultants of New York, New York, New York; LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear and Throat Hospital, New York, New York; Edward S. Harkness Eye Institute, Columbia University College of Physicians and Surgeons, New York, New York.
authors.forename: Marcela
authors.initials: M
authors.lastname: Marsiglia
authors.affiliation: Department of Ophthalmology, New York University School of Medicine, New York, New York.
authors.forename: Sucharita
authors.initials: S
authors.lastname: Boddu
authors.affiliation: Department of Ophthalmology, New York University School of Medicine, New York, New York; Vitreous Retina Macula Consultants of New York, New York, New York; LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear and Throat Hospital, New York, New York; Edward S. Harkness Eye Institute, Columbia University College of Physicians and Surgeons, New York, New York. Electronic address: kbfnyf@aol.com.
authors.forename: K Bailey
authors.initials: KB
authors.lastname: Freund
mesh_terms: D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D020256:Choroidal Neovascularization / Q000145:classification*; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D015994:Incidence; D008297:Male; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity; D057135:Wet Macular Degeneration / Q000145:classification* / Q000175:diagnosis* / Q000188:drug therapy
chemical_list: D020533:Angiogenesis Inhibitors; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A