Journal List > J Korean Ophthalmol Soc > v.54(10) > 1009503

TOOLS
Lee, Lew, Cho, and Kim: Incidence of New Choroidal Neovascularization in Fellow Eyes of Patients Treated for Age-Related Macular Degeneration
Original Article

J Korean Ophthalmol Soc 2013;54(10):1534-1539.

Published online: 3 September 2013

DOI: https://doi.org/10.3341/jkos.2013.54.10.1534

Incidence of New Choroidal Neovascularization in Fellow Eyes of Patients Treated for Age-Related Macular Degeneration

Jung Jin Lee, MD, Young Ju Lew, MD, Sung Won Cho, MD, Jong Woo Kim, MD

Myung-Gok Eye Research Institute, Department of Ophthalmology, Kim's Eye Hospital, Konyang University, Seoul, Korea

Address reprint requests to Young Ju Lew, MD, PhD, Department of Ophthalmology, Kim's Eye Hospital, #136 Yeongsin-ro, Yeongdeungpo-gu, Seoul 150-034, Korea, Tel: 82-1577-2639, Fax: 82-2-2671-6359, E-mail: yjlew@kimeye.com

Received 22 February 2013       Revised 18 April 2013       Accepted 5 August 2013

Copyright © 2013 Korean Ophthalmological Society

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To investigate the development of new choroidal neovascularization in fellow eyes of patients treated for unilateral exudative age-related macular degeneration (AMD).

Methods

Three hundred fourteen patients who were first diagnosed with unilateral exudative AMD and treated with intravitreal bevacizumab or ranibizumab were studied retrospectively.

Results

New exudative AMD developed in 7.0% of fellow eyes after 1 year, 10.8% after 2 years and 13.7% after more than 2 years. According to the subtype of exudative AMD, there were no significant differences between classic CNV, occult or minimally classic CNV, and PCV in the incidence of new exudative AMD. After 2 years, a higher conversion rate was found in the bevacizumab-treated group than the ranibizumab-treated group.

Conclusions

The cumulative incidence of involvement in fellow eyes with exudative AMD was 13.7% over 2 years.

Keywords: Bevacizumab, Exudative age-related macular degeneration, Incidence, Ranibizumab

References

1. Friedman DS, O'Colmain BJ, Muñoz B. . Prevalence of age- related macular degeneration in the united states. Arch Ophthalmol. 2004; 122:556–72.
2. Kawasaki R, Yasuda M, Song JS. . The prevalance of age-related macular degeneration in Asians: a systematic review and meta-analysis. Ophthalmology. 2010; 117:921–7.
3. Park KH, Song SJ, Lee WK. . The results ofnation-wide registry of age-related macular degeneration in Korea. J Korean Ophthalmol Soc. 2010; 51:516–23.
4. Song SJ, Youm DJ, Chang Y, Yu HG. Age-related macular degeneration in a screened Korean population: prevalence, risk factors and subtypes. Ophthalmic Epidemiol. 2009; 16:304–10.
5. Klein R, Klein BE, Jensen SC, Meuer SM. The Five-year incidence and progression of age-related maculopahty: the Beaver Dam Eye Study. Ophthalmology. 1997; 104:7–21.
6. Klein R, Klein BE, Knudtson MD. . Fifteen-year cumulative incidence of age-related macular degeneration: the Beaver Dam Eye Study. Ophthalmology. 2007; 114:253–62.
7. Mukesh BN, Dimitrov PN, Leikin S. . Five-year incidence of age-related maculopathy: the Visual Impariment Proj ect. Ophthalmology. 2004; 111:1176–82.
8. van Leeuwen R, Klaver CC, Vingerling JR. . The risk and natural course of age-related maculopathy: follow-up at 6 1/2 years in the Rotterdam study. Arch Ophthalmol. 2003; 121:519–26.
9. Barbazetto IA, Saroj N, Shapiro H. . Incidence of new choroidal neovascularization in fellow eyes of patients treated in the MARINA and ANCHOR trials. Am J Ophthalmol. 2010; 149:939–46.e1.
crossref
10. Ueta T, Iriyama A, Francis J. . Development of typical age-related macular degeneration and polypoidal choroidal vasculopathy in fellow eyes of Japanese patients with exudative age-related macular degeneration. Am J Ophthalmol. 2008; 146:96–101.
crossref
11. Klaver CC, Assink JJ, van Leeuwen R. . Incidence and progression rate of age-related maculopathy: the Rotterdam study. Invest Ophthalmol Vis Sci. 2001; 42:2237–41.
12. Neri P, Mariotti C, Mercanti L, Salvolini S. . Vitritis in the contralateral uninjected eye following intravitreal bevacizumab (Avastin). Int Ophthalmol. 2008; 28:425–7.
crossref
13. Avery RL, Pearlman J, Pieramici DJ. . Intravitreal bevacizumab (Avastin) in the treatment of proliferative diabetic retinopathy. Ophthalmology. 2006; 113:1695.e1–15.
crossref
14. Sawada O, Kawamura H, Kakinoki M, Ohji M. Vascular endothelial growth factor in fellow eyes of eyes injected with intravitreal bevacizumab. Graefes Arch Clin Exp Ophthalmol. 2008; 246:1379–81.
crossref
15. Bakri SJ, Snyder MR, Reid JM. . Pharmacokinetics of intravitreal bevacizumab (Avastin). Ophthalmology. 2007; 114:855–9.
crossref
16. Bakri SJ, Snyder MR, Reid JM. . Pharmacokinetics of intravitreal ranibizumab (Lucentis). Ophthalmology. 2007; 114:2179–82.
crossref

Figure 1.
Incidence of new neovascular AMD in the fellow eye.
jkos-54-1534f1.tif
Figure 2.
Fundus photograph and fluorescein angiograph of the right eye of a 64 year old female (A, B, C); left eye (D, E, F). (A, B, C) No specific abnormality (D) Choroidal neovascular membrane (CNVM) of the macula with retinal hemorrhage. (E) Predominant classic choroidal neovascularizaion with well demarcated lesion 23 seconds after injection. (F) Late phase shows staining implying old lesions. She was treated with intravitreal Ranibizumab injection 3 times.
jkos-54-1534f2.tif
Figure 3.
Fundus photograph and fluorescein angiograph of same patient with figure 2 after 2 months of right visual disturbance. Right eye (A, B, C) and left eye (D, E, F). (A) New hemorrhagic spot around macula (B, C) Class choroidal neovascularization which was absent 2 months prior (D) Retinal hemorrhage was decreased with fibrotic tissue changes. (E, F) Scar change with staining.
jkos-54-1534f3.tif
Table 1.
Baseline characteristics of patients with unilateral exudative age-related macular degeneration (AMD) at baseline
Predominant classic CNV (n = 99) Occult/Minimally classic CNV (n = 130) PCV (n = 85) p-value
Age (years) 66.6 ± 8.2 67.9 ± 8.9 65.8 ± 8.7 0.78
Sex (M:F) 50:49 78:52 57:28 0.43
Initial AMD VA (log MAR) 0.85 ± 0.66 0.77 ± 0.58 0.89 ± 0.64 0.83
Fellow eye VA (log MAR) 0.12 ± 0.19 0.14 ± 0.27 0.11 ± 0.18 0.90
 Treatment
 Bevacizumab 28 (34.6%) 57 (57.0%) 15 (23.1%) 0.13
 Ranibizumab 38 (46.9%) 35 (35.0%) 50 (76.9%) 0.20
 Mixed 33 (40.7%) 38 (38.0%) 20 (30.8%) 0.34
Number of Tx. 4.5 ± 2.4 4.5 ± 2.1 4.5 ± 2.1 0.82

Values are presented as mean ± SD.

NV = choroidal neovascularization; PCV = polypoidal choroidal vasculopathy.

Table 2.
Number(%) of patients with fellow eyes exudative AMD conversion in each type of AMD
1 year 2 years Over 2 years
Predominant classic CNV (N = 99) 5 (5.1) 9 (9.1) 12(12.1)
Occult / Minimally classic CNV (N = 130) 9 (6.9) 13 (10.0) 18 (13.8)
PCV (N = 85) 8 (9.4) 12 (14.1) 13 (15.3)
p-value 0.51 0.51 0.82

CNV = choroidal neovascularization; PCV = polypoidal choroidal vasculopathy.

Table 3.
Number (%) of patients with fellow eyes exudative AMD conversion in each type of treatment
1 year 2 years Over 2 years
Bevacizumab (n = 100) 7 (7.0%) 16 (16.0%) 21 (21.0%)
Ranibizumab (n = 123) 10 (8.1%) 12 (9.8%) 13 (10.6%)
Mixed (n = 91) 5 (5.5%) 6 (5.5%) 9 (9.9%)
p-value 0.76 0.10 0.03
TOOLS
Similar articles