Neovascular AMD with high recurrences and atrophic areas - Potential relationship between neovascular complication and atrophy

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Abstract

Purpose

To evaluate the possible relationship between Neovascular complication and atrophy and each one characteristics input

Methods

144 eyes of 72 patients, 21 men, 51 women, 72 with retrofoveolar neovascularisation complicating AMD, high recurrences, and atrophic areas,72 controlateral eye with atrophic areas only. First and 2 months’ interval follow-up exam included ETDRS visual acuity (VA), complete ophthalmic examination, fluorescein and infracyanine (ICG) angiography, optical coherence tomography (OCT), (HRA Spectralis-OCT), Autofluorescence imaging (FAF),( region finder software,to evaluate Atrophic areas). Protocol treatment: Series of 3 monthly Ranibizumab IVT, in loading dose and as Neovascular activity needed. Atrophic areas characteristics, their growth way were studied. The impacts of atrophy on high recurrence Neovascular AMD, and vice versa are valuate, compared to own atrophy evolution and average Neovascular evolving way

Results

VA improved in 34% cases, stabilized in 37%. Total Atrophic area surface was 0- 5mm2 in 65%, (4, 898 mm2average),with moderate(1,817 mm2average)and slow (1,481 mm2/year average) growth.14% more in Neovascular eye. 24% more than low recurrences Neovascular AMD. Little correlation between Atrophy growth and number of Neovascular recurrences. Both are different process. Being together increase Neovascular risk and lower treatment response. This protocol had good functional results, with less IVT needed even if frequent recurrences, and a little impact on the evolution of atrophic areas

Conclusion

Potential relationship between Neovascular and Atrophic process is a main question in the AMD follow –up, protocol treatments options,etiopathogenic knowledge and therapeutic prospects.

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