The Regional Distribution of Macular Neovascularization Type 3, a Novel Insight Into Its Etiology

Purpose: To explore the regional distribution of macular neovascularization type 3 (MNV3). Methods: Seventy-eight eyes of 78 patients were reviewed. We defined the location of each lesion after applying a modified ETDRS grid and the incidence of simultaneous MNV1 or 2. Also, we investigated the distribution of MNV3 at the outline of the foveal avascular zone and when the diameter of foveal avascular zone was less than 325 mm. Results: The distribution of MNV3 was 4 lesions (5%) from the center to 500 mm, 72 (92%) from 500 mm to 1500 mm, and 2 (3%) from 1,500 mm to 3000 mm. The distribution in respect of the ETDRS fields was 7 (9%) nasal, 16 (20%) superior, 32 (40%) temporal, and 23 (31%) inferior. No additional MNV1 or 2 were found elsewhere. Most lesions tended to distribute along straight bands radiating from the perifoveal area, mainly in the temporal half (72%). None of the cases had MNV3 at the boundary of the foveal avascular zone. Only five cases had foveal avascular zone diameter of less than 325 mm, the closest lesion was 425 mm away from the center. Conclusion: MNV3 lesions are most likely neither symmetrical nor uniformly distributed. They have a higher affinity to distribute radially in the temporal perifoveal area. RETINA 40:2255–2262, 2020

[1]  K. Bailey Freund,et al.  REDUCED CHORIOCAPILLARIS FLOW IN EYES WITH TYPE 3 NEOVASCULARIZATION AND AGE-RELATED MACULAR DEGENERATION , 2018, Retina.

[2]  G. Querques,et al.  Intraretinal Correlates of Reticular Pseudodrusen Revealed by Autofluorescence and En Face OCT. , 2017, Investigative ophthalmology & visual science.

[3]  Christian Simader,et al.  The Distribution of Leakage on Fluorescein Angiography in Diabetic Macular Edema: A New Approach to Its Etiology. , 2017, Investigative ophthalmology & visual science.

[4]  Jae Hui Kim,et al.  RECURRENCE IN PATIENTS WITH TYPE 3 NEOVASCULARIZATION (RETINAL ANGIOMATOUS PROLIFERATION) AFTER INTRAVITREAL RANIBIZUMAB , 2017, Retina.

[5]  Richard F Spaide,et al.  IMPROVING THE AGE-RELATED MACULAR DEGENERATION CONSTRUCT: A New Classification System. , 2017, Retina.

[6]  G. R. Jackson,et al.  Delayed Rod-Mediated Dark Adaptation Is a Functional Biomarker for Incident Early Age-Related Macular Degeneration. , 2016, Ophthalmology.

[7]  Jae Hui Kim,et al.  Fellow‐eye neovascularization in unilateral retinal angiomatous proliferation in a Korean population , 2016, Acta ophthalmologica.

[8]  E. Agrón,et al.  Impairments in Dark Adaptation Are Associated with Age-Related Macular Degeneration Severity and Reticular Pseudodrusen. , 2015, Ophthalmology.

[9]  Jay S Duker,et al.  A review of optical coherence tomography angiography (OCTA) , 2015, International Journal of Retina and Vitreous.

[10]  S. Kinoshita,et al.  SUBFOVEAL CHOROIDAL THICKNESS IN RETINAL ANGIOMATOUS PROLIFERATION , 2014, Retina.

[11]  B. Kirchhof,et al.  Environmental and genetic risk factors for retinal angiomatous proliferation , 2014, Acta ophthalmologica.

[12]  Dean Y. Li,et al.  Photoreceptor avascular privilege is shielded by soluble VEGF receptor-1 , 2013, eLife.

[13]  U. Schmidt-Erfurth,et al.  The role of the macular intraretinal cysts in evolution of capillary drop out in diabetic macular retinopathy. A new mechanism , 2013 .

[14]  P. Heiduschka,et al.  Localized reticular pseudodrusen and their topographic relation to choroidal watershed zones and changes in choroidal volumes. , 2013, Investigative ophthalmology & visual science.

[15]  C. Curcio,et al.  SUBRETINAL DRUSENOID DEPOSITS IN NON-NEOVASCULAR AGE-RELATED MACULAR DEGENERATION: Morphology, Prevalence, Topography, and Biogenesis Model , 2013, Retina.

[16]  K. Matsuo,et al.  CFH and ARMS2 variations in age-related macular degeneration, polypoidal choroidal vasculopathy, and retinal angiomatous proliferation. , 2010, Investigative ophthalmology & visual science.

[17]  S. Kishi,et al.  TOMOGRAPHIC FEATURES OF INTRARETINAL NEOVASCULARIZATION IN RETINAL ANGIOMATOUS PROLIFERATION , 2010, Retina.

[18]  R. Spaide,et al.  Enhanced Depth Imaging Optical Coherence Tomography of the Choroid in Normal Eyes , 2009 .

[19]  David J. Wilson,et al.  Clinicopathologic correlation of retinal angiomatous proliferation. , 2008, Archives of ophthalmology.

[20]  H. Koizumi,et al.  Choroidal circulatory disturbances associated with retinal angiomatous proliferation on indocyanine green angiography , 2008, Graefe's Archive for Clinical and Experimental Ophthalmology.

[21]  L. Yannuzzi,et al.  Review of retinal angiomatous proliferation or type 3 neovascularization. , 2008, Retina.

[22]  L. Yannuzzi,et al.  TYPE 3 NEOVASCULARIZATION: The Expanded Spectrum of Retinal Angiomatous Proliferation , 2008, Retina.

[23]  R. Zawadzki,et al.  HIGH RESOLUTION FOURIER-DOMAIN OPTICAL COHERENCE TOMOGRAPHY OF RETINAL ANGIOMATOUS PROLIFERATION , 2007, Retina.

[24]  W. März,et al.  Association of complement factor H Y402H gene polymorphism with different subtypes of exudative age-related macular degeneration. , 2007, Ophthalmology.

[25]  T. Desmettre,et al.  Types of choroidal neovascularisation in newly diagnosed exudative age-related macular degeneration , 2007, British Journal of Ophthalmology.

[26]  M. Yuzawa,et al.  Clinicopathological findings of retinal angiomatous proliferation , 2007, Graefe's Archive for Clinical and Experimental Ophthalmology.

[27]  S. Hayreh.  Posterior ciliary artery circulation in health and disease: the Weisenfeld lecture. , 2004, Investigative ophthalmology & visual science.

[28]  A. Agarwal,et al.  Focal Inner Retinal Hemorrhages in Patients with Drusen: An Early Sign of Occult Choroidal Neovascularization and Chorioretinal Anastomosis , 2003, Retina.

[29]  K. Bartz-Schmidt,et al.  Clinicopathological correlation of deep retinal vascular anomalous complex in age related macular degeneration , 2000, The British journal of ophthalmology.

[30]  G. Soubrane,et al.  Imaging of chorioretinal anastomoses in vascularized retinal pigment epithelium detachments. , 1995, Archives of ophthalmology.

[31]  C. Curcio,et al.  Aging of the human photoreceptor mosaic: evidence for selective vulnerability of rods in central retina. , 1993, Investigative ophthalmology & visual science.

[32]  S S Hayreh,et al.  Segmental nature of the choroidal vasculature. , 1975, The British journal of ophthalmology.

[33]  E Yamada,et al.  Some structural features of the fovea centralis in the human retina. , 1969, Archives of ophthalmology.

[34]  G. Mcgwin,et al.  Aqueous humor levels of vascular endothelial growth factor before and after intravitreal bevacizumab in type 3 versus type 1 and 2 neovascularization: a prospective, case-control study. , 2012, American journal of ophthalmology.

[35]  T. Kern,et al.  Vascular lesions in diabetes are distributed non-uniformly within the retina. , 1995, Experimental eye research.

[36]  H. Gao,et al.  Aging of the human retina. Differential loss of neurons and retinal pigment epithelial cells. , 1992, Investigative ophthalmology & visual science.

[37]  S. Hayreh.  In vivo choroidal circulation and its watershed zones , 1990, Eye.