Decreased visual acuity associated with cystoid macular edema in neovascular age-related macular degeneration

Abstract

Objective: To determine the prevalence and visual significance of cystoid macular edema (CME) in eyes with subfoveal neovascular age-related macular degeneration using optical coherence tomography (OCT).

Materials and methods: The medical records of 61 consecutive patients initially seen with nondisciform subfoveal neovascular age-related macular degeneration were retrospectively reviewed. All patients underwent fluorescein angiography and OCT imaging. Eyes with intraretinal hyporeflective spaces in the macula in the OCT images were considered to have CME.

Results: Twenty-eight (46%) of 61 eyes demonstrated CME on the OCT images. The presence of CME and increased foveal thickness correlated with decreased visual acuity, but not with the duration of symptoms. Twenty-six (93%) of 28 eyes with CME contained classic choroidal neovascularization, whereas 16 (48%) of 33 eyes without CME contained classic choroidal neovascularization.

Conclusions: Cystoid macular edema is a common finding in patients with choroidal neovascularization associated with age-related macular degeneration. The presence of CME and foveal thickening is associated with worse visual acuity in these patients. Cystoid macular edema is more common with choroidal neovascularization containing classic component. The OCT is a useful test to detect the presence of CME in these patients since CME may be difficult to identify on fluorescein angiogram.