PURPOSE: To investigate the prevalence and clinical significance of cystoid macular degeneration in eyes that underwent intravitreal ranibizumab injections for exudative age-related macular degeneration. DESIGN: Retrospective, interventional case series. METHODS: We reviewed the charts of 56 consecutive patients (19 male, 37 female; mean age +/- standard deviation, 80.81 +/- 4.8 years) with exudative age-related macular degeneration who received the last intravitreal ranibizumab injection at least 6 months before and were judged to have a fibroatrophic scar without signs of progression by fluorescein angiography or spectral-domain optical coherence tomography. Main outcome measures were the estimated prevalence and clinical significance of cystoid macular degeneration. RESULTS: Twenty-two eyes showed various combinations of degenerative pseudocysts, whereas 34 eyes did not show any pseudocysts. The 95% confidence interval for the prevalence estimate was 36.98% to 41.02%. Degenerative pseudocysts appeared square-shaped, did not change their overall appearance over time, and were located just below the internal limiting membrane in 11 eyes (50%), in the inner nuclear layer in 16 eyes (72.7%), in the outer nuclear layer in 8 eyes (36.3%), and in all the retinal layers in 6 eyes (27.2%). Best-corrected visual acuity improved in eyes with and without degenerative pseudocysts and decreased significantly in eyes with degenerative pseudocysts (P = .03). Mean central macular thickness decreased significantly (P < .001) to 324.1 mu m and to 328.2 mu m in eyes and without degenerative pseudocysts, respectively. CONCLUSIONS: Cystoid macular degeneration represents a well-distinguished clinical entity that may be detected in exudative age-related macular degeneration eyes showing a posttreatment fibroatrophic scar and should not be considered as a manifestation of choroidal neovascularization activity. (Am J Ophthalmol 2011; 152:100-107. (C) 2011 by Elsevier Inc. All rights reserved.)
Cystoid Macular Degeneration in Exudative Age-Related Macular Degeneration
QUERQUES , GIUSEPPE;
2011-01-01
Abstract
PURPOSE: To investigate the prevalence and clinical significance of cystoid macular degeneration in eyes that underwent intravitreal ranibizumab injections for exudative age-related macular degeneration. DESIGN: Retrospective, interventional case series. METHODS: We reviewed the charts of 56 consecutive patients (19 male, 37 female; mean age +/- standard deviation, 80.81 +/- 4.8 years) with exudative age-related macular degeneration who received the last intravitreal ranibizumab injection at least 6 months before and were judged to have a fibroatrophic scar without signs of progression by fluorescein angiography or spectral-domain optical coherence tomography. Main outcome measures were the estimated prevalence and clinical significance of cystoid macular degeneration. RESULTS: Twenty-two eyes showed various combinations of degenerative pseudocysts, whereas 34 eyes did not show any pseudocysts. The 95% confidence interval for the prevalence estimate was 36.98% to 41.02%. Degenerative pseudocysts appeared square-shaped, did not change their overall appearance over time, and were located just below the internal limiting membrane in 11 eyes (50%), in the inner nuclear layer in 16 eyes (72.7%), in the outer nuclear layer in 8 eyes (36.3%), and in all the retinal layers in 6 eyes (27.2%). Best-corrected visual acuity improved in eyes with and without degenerative pseudocysts and decreased significantly in eyes with degenerative pseudocysts (P = .03). Mean central macular thickness decreased significantly (P < .001) to 324.1 mu m and to 328.2 mu m in eyes and without degenerative pseudocysts, respectively. CONCLUSIONS: Cystoid macular degeneration represents a well-distinguished clinical entity that may be detected in exudative age-related macular degeneration eyes showing a posttreatment fibroatrophic scar and should not be considered as a manifestation of choroidal neovascularization activity. (Am J Ophthalmol 2011; 152:100-107. (C) 2011 by Elsevier Inc. All rights reserved.)I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
