Predictors of structural findings in old disciform lesions

To analyze the baseline findings predictive of the size and type of the late exudative age-related macular degeneration (AMD) lesions.

Observational case series.

Retrospective study.

University clinic referral practice.

The records of 167 consecutive patients initially diagnosed with recent choroidal neovascularization (CNV) related to AMD were analyzed 4.8 to 9.2 (mean 6.8) years after baseline. Of 121 patients still living, 74 attended the reexamination. After exclusions, data from 61 patients were analyzed.

From the fundus photographs and fluorescein angiographic images taken at baseline and at follow-up the size and components of AMD lesion were measured. The presence of hemorrhage, pigment epithelial detachment (PED), classic CNV, laser treatment, and involvement of the fellow eye were recorded at baseline.

Lesion size, increase in lesion size, persistent exudative process, subretinal fibrosis, and chorioretinal anastomosis at the follow-up examination.

Large lesion (P <.001) and CNV (P =.003) sizes, and the presence of occult, no classic CNV (P =.013) at baseline predict a large lesion at follow-up. Other factors predicting a large lesion were subfoveal (P =.019) and bilateral lesions (P =.017) and the presence of hemorrhage (P =.012) at baseline. A large (P =.040) and bilateral lesion (P =.040) and hemorrhage (P =.011) at baseline were correlated with subretinal fibrosis at follow-up. Occult lesions (P =.002) at baseline were correlated with chorioretinal anastomosis at follow-up.

The type and size of the late AMD lesion can partly be predicted from baseline characteristics.