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Neovascular age-related macular degeneration presenting at extremities of age: a comparative study

  • Retinal Disorders
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Abstract

Purpose

To compare the characteristics and response to treatment between patients with NVAMD presenting at the extremities of the AMD age spectrum.

Methods

Fifty-four eyes of 47 patients were included in this retrospective study, divided by age at NVAMD presentation under 65 (n = 15) or over 85 (n = 39) years. All patients were initially treated with 3 monthly bevacizumab injections, followed by a PRN protocol. Clinical parameters and OCT characteristics were recorded and analyzed at presentation, after the initial 3 monthly injections and at 1 year.

Results

At presentation, patients in the young group had significantly higher rates of subretinal fluid (p = 0.005), a polypoidal choroidal vasculopathy–like pattern (p < 0.01) and a history of smoking (p = 0.004). Submacular hemorrhage and pigment epithelial detachments were more common in young patients, and intraretinal fluid was more common in elderly patients (all with borderline statistical significance). VA improved significantly more in the younger patients at 3 months and 1 year (p = 0.001 and 0.002, respectively), despite similar treatment protocols and mean number of injections. Bilateral involvement at baseline was more common in elderly patients (p = 0.008). The differences in OCT characteristics between groups remained throughout the study period.

Conclusion

There are considerable differences in the clinical manifestations and response to treatment between NVAMD patients at the extremities of the AMD age spectrum. Different pathophysiological, systemic, and genetic factors may play a role in such patients.

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Authors and Affiliations

  1. Department of Ophthalmology, Meir Medical Center, 59 Tshernichovsky St., 4428164, Kfar Saba, Israel

    Alexander Rubowitz, Saleh Esa, Maayan Fradkin & Elad Moisseiev

  2. Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel

    Alexander Rubowitz & Elad Moisseiev

Authors
  1. Alexander Rubowitz
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  2. Saleh Esa
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  3. Maayan Fradkin
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Correspondence to Elad Moisseiev.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the Meir Medical Center and Clalit Healthcare Organization and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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This is a retrospective study that did not require informed consent.

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Rubowitz, A., Esa, S., Fradkin, M. et al. Neovascular age-related macular degeneration presenting at extremities of age: a comparative study. Graefes Arch Clin Exp Ophthalmol 258, 2399–2405 (2020). https://doi.org/10.1007/s00417-020-04893-4

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  • DOI: https://doi.org/10.1007/s00417-020-04893-4

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