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. 2019 Jun 4;14(6):e0217805.
doi: 10.1371/journal.pone.0217805. eCollection 2019.

Progression of subclinical choroidal neovascularization in age-related macular degeneration

Michael J Heiferman  1 , Amani A Fawzi  1
Affiliations

Progression of subclinical choroidal neovascularization in age-related macular degeneration

Michael J Heiferman et al. PLoS One. .

Abstract

Purpose: To use optical coherence tomography angiography (OCTA) to study longitudinal subclinical choroidal neovascularization (CNV) changes and their correlation with progression to exudation in age-related macular degeneration (AMD).

Methods: This study included a total of 34 patients with unilateral neovascular AMD who were evaluated prospectively using OCTA to detect subclinical CNV in their fellow eye. Eyes with baseline subclinical CNV were followed with serial OCTA for a minimum of one year (15.2±3.27 months) to monitor the development of exudation.

Results: Of the 34 fellow eyes studied, five were found to have baseline subclinical CNV. One of the five cases of baseline subclinical CNV converted to exudative AMD during the follow up period. The average surface area of baseline subclinical CNV on OCTA was 0.131±0.096 mm2 which progressed to 0.136±0.104 mm2 at the final follow up (P = 0.539). Geographic atrophy grew at a rate of 0.82±1.20mm2/year in four eyes without subclinical CNV and 0.02mm2/year in one eye with subclinical CNV.

Conclusion and importance: The rate of conversion to exudative AMD in eyes with subclinical CNV of 20% in our study is similar to previous reports and suggests the importance of vigilance in these eyes. The lower growth rate of geographic atrophy may suggest a protective effect of subclinical CNV that deserves further study.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Example of subclinical CNV analysis.
A: En face OCTA slab of subclinical CNV. B: Flow area selection tool used in the AngioVue software. C: OCTA B-scan with flow marked in red. The horizontal green line seen in panel A marks the section of OCTA B-scan image. D: The same OCTA B-scan segmented 72 microns below (green line) the inner plexiform layer to Bruch’s membrane (red line).
Fig 2
Fig 2. Case of subclinical CNV that converted to exudative AMD.
Fig 3
Fig 3. Case of subclinical CNV that remained relatively stable in surface area and flow area.
See this image and copyright information in PMC

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