TY - JOUR
T1 - Type 3 neovascularization
T2 - Evolution, association with pigment epithelial detachment, and treatment response as revealed by spectral domain optical coherence tomography
AU - Nagiel, Aaron
AU - Sarraf, David
AU - Sadda, Srinivas R.
AU - Spaide, Richard F.
AU - Jung, Jesse J.
AU - Bhavsar, Kavita V.
AU - Ameri, Hossein
AU - Querques, Giuseppe
AU - Freund, K. Bailey
PY - 2015/4/1
Y1 - 2015/4/1
N2 - Purpose: To demonstrate the evolution and treatment response of Type 3 neovascularization using spectral domain optical coherence tomography. Methods: We retrospectively analyzed 40 eyes treated with intravitreal anti-vascular endothelial growth factor therapy for Type 3 neovascularization over a variable follow-up period. Results: In 17 eyes, spectral domain optical coherence tomography captured the development of Type 3 neovascularization from punctate hyperreflective foci that preceded any outer retinal defect. The more mature Type 3 lesions were associated with outer retinal disruption and adjacent cystoid macular edema. In addition, 37 of 40 Type 3 lesions (93%) were associated with an underlying pigment epithelial detachment, of which 26 (70%) were drusenoid, 6 (16%) serous, and 5 (14%) mixed. Type 3 vessels appeared to leak fluid into the pigment epithelial detachment cavity, creating serous pigment epithelial detachments as large as 925 m in maximal height. Treatment with anti-vascular endothelial growth factor agents led to prompt involution of the lesion and resorption of the intraretinal and subretinal pigment epithelium fluid after one or two injections (median 1). Conclusion: In some eyes with age-related macular degeneration, the earliest sign of Type 3 neovascularization is punctate hyperreflective foci above the external limiting membrane. The mature Type 3 lesions and associated serous pigment epithelial detachments are highly responsive to anti-vascular endothelial growth factor therapy.
AB - Purpose: To demonstrate the evolution and treatment response of Type 3 neovascularization using spectral domain optical coherence tomography. Methods: We retrospectively analyzed 40 eyes treated with intravitreal anti-vascular endothelial growth factor therapy for Type 3 neovascularization over a variable follow-up period. Results: In 17 eyes, spectral domain optical coherence tomography captured the development of Type 3 neovascularization from punctate hyperreflective foci that preceded any outer retinal defect. The more mature Type 3 lesions were associated with outer retinal disruption and adjacent cystoid macular edema. In addition, 37 of 40 Type 3 lesions (93%) were associated with an underlying pigment epithelial detachment, of which 26 (70%) were drusenoid, 6 (16%) serous, and 5 (14%) mixed. Type 3 vessels appeared to leak fluid into the pigment epithelial detachment cavity, creating serous pigment epithelial detachments as large as 925 m in maximal height. Treatment with anti-vascular endothelial growth factor agents led to prompt involution of the lesion and resorption of the intraretinal and subretinal pigment epithelium fluid after one or two injections (median 1). Conclusion: In some eyes with age-related macular degeneration, the earliest sign of Type 3 neovascularization is punctate hyperreflective foci above the external limiting membrane. The mature Type 3 lesions and associated serous pigment epithelial detachments are highly responsive to anti-vascular endothelial growth factor therapy.
KW - Type 3 neovascularization
KW - age-related macular degeneration
KW - hyperreflective foci
KW - optical coherence tomography
KW - pigment epithelial detachment
KW - retinal angiomatous proliferation
KW - vascular endothelial growth factor
UR - http://www.scopus.com/inward/record.url?scp=84926195560&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84926195560&partnerID=8YFLogxK
U2 - 10.1097/IAE.0000000000000488
DO - 10.1097/IAE.0000000000000488
M3 - Article
C2 - 25650713
AN - SCOPUS:84926195560
SN - 0275-004X
VL - 35
SP - 638
EP - 647
JO - Retina
JF - Retina
IS - 4
ER -