Yanagi Y, et al. - Researchers ascertained the incidence of fellow eye involvement in patients presenting with unilateral typical age-related macular degeneration (AMD) or polypoidal choroidal vasculopathy. They also assessed the patterns of OCT-A changes within 6 months before the onset of exudative changes, especially focusing on nonexudative neovascularization. The development of exudative changes could be predisposed by the presence of nonexudative neovascularization.

Methods

• Authors took the data for this study from a prospective, observational cohort study involving Asian patients with exudative AMD in the Asian AMD Phenotyping Study between October 2015 and March 2016.
• They began the analyses began in June 2017.
• They included only the patients who had gradable OCT-A and indocyanine green angiography (ICGA) scans of the fellow eye at baseline and follow-up at least 6 months apart.
• Experts assessed the contralateral eye for presence of nonexudative neovascularization based on multimodal imaging, which included ICGA, spectral domain optical coherence tomography, and OCT-A.
• The main outcomes and measures were the difference between the incidence of those with nonexudative choroidal neovascularization and those without as analyzed using log-rank test and qualitative analysis of OCT-A images.

Results

• As per the data, 95 fellow eyes of 95 patients who presented with unilateral exudative AMD with a mean (SD) age of 68.6 (8.6) years were included.
• Findings suggested that nonexudative neovascularization was present in 18 eyes (19%) (8 [22.9%] and 10 [19.0%] fellow eyes with typical AMD and polypoidal choroidal vasculopathy, respectively; 8 [44.4%] on OCT-A; 5 [27.8%] on ICGA; and 5 [27.8%] on both OCT-A and ICGA).
• In 6 fellow eyes (6.3%), development of exudative changes were seen.
• From previously noted nonexudative neovascularization, 4 eyes developed exudation, and 2 eyes arose exudative changes from de novo.
• Results demonstrated significantly higher probability of developing exudation within 6 months in eyes with baseline nonexudative neovascularization (0.087; 95% CI, 0.0033-0.210) compared with eyes without (0.010; 95% CI, 0.0026-0.041) (P = .008).
• Authors noted that, compared with baseline there was an increase in the size of network vessels in all eyes whose OCT-A images were available immediately before the onset of exudative changes.