INTRODUCTIONThe purpose of this review is to combine the results of existing literature on the natural history of occult choroidal neovascularisation (CNV) associated with age-related macular degeneration (AMD).

MATERIALS AND METHODSPublished reports evaluating eyes with occult CNV in AMD patients were selected for meta-analysis based on a computerised MEDLINE search. Pooled estimates of the proportions of eyes with a vision loss greater than 2 to 3 (moderate vision loss) or 6 lines (severe vision loss) at 1 year and 2 to 3 years, respectively, or developing a classic component on fluorescein angiography at 1 year were measured.

RESULTSThere is no significant heterogeneity among published rates of visual loss and development of classic CNV. The overall pooled estimates (95% confidence limits) of the proportions of eyes with at least moderate or severe vision loss, respectively, were 59% (53% to 64.5%) and 34% (25% to 43%) at 1 year and 70% (64% to 76%) and 47% (40% to 54%) at 2 to 3 years; the overall pooled estimate of the percentage of eyes developing classic CNV at 1 year was 46% (39% to 54%).

CONCLUSIONA substantial number of patients with occult CNV from AMD will develop at least moderate visual loss at 1 year and severe visual loss within 3 years. However, visual acuity may remain stable in up to 30% of patients. These results may help us to understand the exact role of new therapies and in planning future trials.

Choroidal Neovascularization ; complications ; physiopathology ; Humans ; Macular Degeneration ; complications ; physiopathology ; Vision, Low ; etiology

INTRODUCTIONThe aim of this review was to describe the use of optical coherence tomography (OCT) in the diagnosis and management of retinal angiomatous proliferation (RAP) in patients with age-related macular degeneration (AMD).

MATERIALS AND METHODSWe reviewed the tomographic characteristics of the eyes affected by RAP seen at our institution and imaged by OCT. Some eyes with RAP were also studied with OCT prior to and after laser treatment to determine the tomographic changes following laser photocoagulation.

RESULTSIn this preliminary report, OCT showed a typical pattern of structural changes in RAP: increased foveal thickness, cystoid macular oedema (CME) consisting of large central cysts and smaller cystoid spaces located mainly in the outer retinal layers, serous retinal detachment and a highly reflective intraretinal mass overlying a highly or moderately elevated retinal pigment epithelium (RPE). This mass corresponded to the hot spot observed on ICG angiography. After successful laser photocoagulation, significant decrease in foveal thickness, complete resolution of CME and retinal detachment with thinning of the neurosensory retina overlying the treated area could be observed.

CONCLUSIONSOCT appears to be useful in evaluating and documenting RAP in AMD patients both before and after laser photocoagulation. Longitudinal studies are required to determine its exact place and utility in clinical practice.

Angiomatosis ; etiology ; pathology ; surgery ; Humans ; Laser Coagulation ; Macular Degeneration ; complications ; Retinal Diseases ; etiology ; pathology ; surgery ; Tomography, Optical Coherence