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Updated: Jul 13, 2025

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Aneurysmal type 2 neovascularization: A new entity.

J Montero-Hernández1, L Remolí-Sargues1, C Monferrer-Adsuara1

  • 1Department of Ophthalmology, Universitario of Valencia, Consorcio Hospital General, avenida Tres-Cruces, 2, 46014 Valencia, Spain.

Journal Francais D'Ophtalmologie
|October 16, 2023
PubMed
Summary
This summary is machine-generated.

A new pachychoroid disease (PD) entity, aneurysmal type 2 neovascularization (AT2), is described. This condition features subretinal aneurysmal dilatations and does not improve with intravitreal aflibercept treatment due to fibrosis.

Keywords:
Aneurismal type 2 neovascularizationNéovascularisation anévrismale de type 2Optical coherence tomographyPolypoidal choroidal vasculopathyTomographie par cohérence optiqueVasculopathie choroïdienne polypoïdale

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Area of Science:

  • Ophthalmology
  • Neovascularization
  • Choroid Diseases

Background:

  • Pachychoroid disease (PD) encompasses various conditions characterized by choroidal thickening and vascular abnormalities.
  • Aneurysmal type 2 neovascularization (AT2) is a newly identified entity within the PD spectrum.

Approach:

  • Observational retrospective study of three patients with subretinal polyps treated with intravitreal aflibercept.
  • Comprehensive review of clinical and multimodal imaging data, including fundus autofluorescence, indocyanine green angiography, and optical coherence tomography (OCT/OCT-A).
  • Assessment of visual acuity, macular thickness, and choroidal characteristics at baseline and during follow-up.

Key Points:

  • AT2 presents with subretinal granular hypoautofluorescence and prominent branching vascular networks with aneurysmal dilatations on angiography.
  • OCT reveals subretinal aneurysmal lesions, retinal pigment epithelial microtears, the double-layer sign, and pachyvessels.
  • En face OCT-A visualizes telangiectatic networks, while cross-sectional OCT-A shows polyps as hypoflow signals.

Conclusions:

  • AT2 is a novel entity within the pachychoroid disease spectrum.
  • Characterized by subretinal aneurysmal dilatations, choroidal vascular hyperpermeability, choroidal thickening, and pachyvessels.
  • Intravitreal aflibercept did not improve visual acuity, with subretinal fibrosis developing despite reduced macular thickness.