Abstract
Background
When we classified neovascular exudative age-related macular degeneration (AMD) into three types of polypoidal choroidal vasculopathy (PCV), typical AMD, and retinal angiomatous proliferation (RAP) in our previous study, we reported 5.5% had the combined cases, such as one eye had PCV and the other eye had typical AMD. We examined the clinical characteristics of these combined cases in the current study.
Methods
All cases underwent fluorescein and indocyanine green angiography (FA and ICGA) at the initial examination. All PCV cases were diagnosed definitively based on characteristic aneurysmal lesions seen on ICGA. Follow-up examinations also were conducted to determine whether polypoidal lesions had developed in the eyes with typical AMD.
Results
Among 349 patients with neovascular AMD, 20 (5.7%) had one eye with PCV and the other eye with typical AMD. The average age was 73 years. The mean best-corrected visual acuity levels at the initial examination in eyes with PCV and typical AMD were 0.20 and 0.43, respectively (p = 0.09). All subgroups of classic and occult CNV were observed in the eyes with typical AMD on FA. During the follow-up period (average, 21.7 months), PCV developed in ten eyes with typical AMD at the initial examination.
Conclusions
Although some cases might include different stages of progression or probable cases of PCV, the combined cases in which one eye has PCV and the other eye has typical AMD suggest that those clinical entities are not independent and possibly overlap.
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References
Ali F, Chan WC, Stevenson MR, Muldrew KA, Chakravarthy U (2004) Morphometric analysis of angiograms of exudative lesions in age-related macular degeneration. Arch Ophthalmol 122:710–715. doi:10.1001/archopht.122.5.710
Barbazetto I, Burdan A, Bressler NM, Bressler SB, Haynes L, Kapetanios AD, Lukas J, Olsen K, Potter M, Reaves A, Rosenfeld P, Schachat AP, Strong HA, Wenkstern A, Treatment of Age-Related Macular Degeneration with Photodynamic Therapy Study Group (2003) Verteporfin in Photodynamic Therapy Study Group. Photodynamic therapy of subfoveal choroidal neovascularization with verteporfin: fluorescein angiographic guidelines for evaluation and treatment--TAP and VIP report No. 2. Arch Ophthalmol 121:1253–1268. doi:10.1001/archopht.121.9.1253
Dewan A, Liu M, Hartman S, Zhang SS, Liu DT, Zhao C, Tam PO, Chan WM, Lam DS, Snyder M, Barnstable C, Pang CP, Hoh J (2006) HTRA1 promoter polymorphism in wet age-related macular degeneration. Science 314:989–992. doi:10.1126/science.1133807
Gotoh N, Nakanishi H, Hayashi H, Yamada R, Otani A, Tsujikawa A, Yamashiro K, Tamura H, Saito M, Saito K, Iida T, Matsuda F, Yoshimura N (2009) ARMS2 (LOC387715) Variants in Japanese Patients with Exudative Age-related Macular Degeneration and Polypoidal Choroidal Vasculopathy. Am J Ophthalmol 147:1037–1041. doi:10.1016/j.ajo.2008.12.036
Gotoh N, Yamada R, Nakanishi H, Saito M, Iida T, Matsuda F, Yoshimura N (2008) Correlation between CFH Y402H and HTRA1 rs11200638 genotype to typical exudative age-related macular degeneration and polypoidal choroidal vasculopathy phenotype in the Japanese population. Clin Exper Ophthalmol 36:437–442. doi:10.1111/j.1442-9071.2008.01791.x
Ishibashi T, Patterson R, Ohnishi Y, Inomata H, Ryan SJ (1986) Formation of drusen in the human eye. Am J Ophthalmol 101:342–353
Japanese Study Group of Polypoidal Choroidal Vasculopathy (2005) Criteria for diagnosis of polypoidal choroidal vasculopathy (in Japanese). Nippon Gannka Gakkai Zasshi 109:417–427
Klein R, Klein BE, Jensen SC, Meuer SM (1997) The five-year incidence and progression of age-related maculopathy: the Beaver Dam Eye Study. Ophthalmology 104:7–21
Klein R, Klein BE, Tomany SC, Meuer SM, Huang GH (2002) Ten-year incidence and progression of age-related maculopathy: The Beaver Dam Eye Study. Ophthalmology 109:1767–1779. doi:10.1016/S0161-6420(02)01146-6
Kondo N, Honda S, Ishibashi K, Tsukahara Y, Negi A (2007) LOC387715/HTRA1 variants in polypoidal choroidal vasculopathy and age-related macular degeneration in a Japanese population. Am J Ophthalmol 144:608–612. doi:10.1016/j.ajo.2007.06.003
Kondo N, Honda S, Ishibashi K, Tsukahara Y, Negi A (2008) Elastin gene polymorphisms in neovascular age-related macular degeneration and polypoidal choroidal vasculopathy. Invest Ophthalmol Vis Sci 49:1101–1105. doi:10.1167/iovs.07-1145
Ladas ID, Karagiannis DA, Georgalas I, Rouvas AA, Moschos MM, Apostolopoulos M (2004) Polypoidal choroidal vasculopathy associated with Doyne's familial choroiditis: treatment with thermal laser. Eur J Ophthalmol 14:264–268
Maruko I, Iida T, Saito M, Nagayama D, Saito K (2007) Clinical characteristics of exudative age-related macular degeneration in Japanese patients. Am J Ophthalmol 144:15–22. doi:10.1016/j.ajo.2007.03.047
Mitchell P, Wang JJ, Foran S, Smith W (2002) Five-year incidence of age-related maculopathy lesions: the Blue Mountains Eye Study. Ophthalmology 109:1092–1097. Erratum in: Ophthalmology (2002) 109:1588. doi:10.1016/S0161-6420(02)01055-2
Miyazaki M, Kiyohara Y, Yoshida A, Iida M, Nose Y, Ishibashi T (2005) The 5-year incidence and risk factors for age-related maculopathy in a general Japanese population: the Hisayama study. Invest Ophthalmol Vis Sci 46:1907–1910. doi:10.1167/iovs.04-0923
Mori K, Horie-Inoue K, Kohda M, Kawasaki I, Gehlbach PL, Awata T, Yoneya S, Okazaki Y, Inoue S (2007) Association of the HTRA1 gene variant with age-related macular degeneration in the Japanese population. J Hum Genet 52:636–641. doi:10.1007/s10038-007-0162-1
Oshima Y, Ishibashi T, Murata T, Tahara Y, Kiyohara Y, Kubota T (2001) Prevalence of age related maculopathy in a representative Japanese population: the Hisayama study. Br J Ophthalmol 85:1153–1157. doi:10.1136/bjo.85.10.1153
Treatment of Age-related Macular Degeneration With Photodynamic Therapy (TAP) Study Group (1999) Photodynamic therapy of subfoveal choroidal neovascularization in age-related macular degeneration with verteporfin: one-year results of 2 randomized clinical trials–TAP report. Arch Ophthalmol 117:1329–1345
Uyama M, Wada M, Nagai Y, Matsubara T, Matsunaga H, Fukushima I, Takahashi K, Matsumura M (2002) Polypoidal choroidal vasculopathy: natural history. Am J Ophthalmol 133:639–648. doi:10.1016/S0002-9394(02)01404-6
Vingerling JR, Dielemans I, Hofman A, Grobbee DE, Hijmering M, Kramer CF, de Jong PT (1995) The prevalence of age-related maculopathy in the Rotterdam Study. Ophthalmology 102:205–210
Yang Z, Camp NJ, Sun H, Tong Z, Gibbs D, Cameron DJ, Chen H, Zhao Y, Pearson E, Li X, Chien J, Dewan A, Harmon J, Bernstein PS, Shridhar V, Zabriskie NA, Hoh J, Howes K, Zhang K (2006) A variant of the HTRA1 gene increases susceptibility to age-related macular degeneration. Science 314:992–993. doi:10.1126/science.1133811
Yoshida T, DeWan A, Zhang H, Sakamoto R, Okamoto H, Minami M, Obazawa M, Mizota A, Tanaka M, Saito Y, Takagi I, Hoh J, Iwata T (2007) HTRA1 promoter polymorphism predisposes Japanese to age-related macular degeneration. Mol Vis 13:545–548
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Maruko, I., Iida, T., Saito, M. et al. Combined cases of polypoidal choroidal vasculopathy and typical age-related macular degeneration. Graefes Arch Clin Exp Ophthalmol 248, 361–368 (2010). https://doi.org/10.1007/s00417-009-1276-2
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DOI: https://doi.org/10.1007/s00417-009-1276-2