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Alfredo Pece, MD; Gianluigi Bolognesi, MD; Ugo Introini, MD; Giorgio Pacelli, MD; Giliola Calori, MD; Rosario Brancato, MD

Arch Ophthalmol. 2000;118:630-634.

Objective  To determine the natural course of well-defined plaque choroidal neovascularization (CNV) using indocyanine green angiography.

Methods  Two ophthalmologists, experts in macular diseases and indocyanine green angiography, examined 40 eyes with exudative age-related macular degeneration and a well-defined plaque CNV using complete ophthalmoscopic evaluation, fluorescein angiography, and indocyanine green angiography. The increase in the size of the plaques was analyzed using multivariate analysis, in relation to the worsening of visual acuity, with adjustment for age, sex, and length of follow-up.

Results  Mean follow-up was 13.5 months (median, 11 months). Initial and final mean visual acuity were 20/46 (median, 20/50) and 20/65 (median, 20/100), respectively. The mean initial size of the plaque was 6.62 mm² (median, 6.20 mm²), and the mean final size was 10.40 mm² (median, 9.76 mm²). The enlargement was statistically significant (P<.001).

Conclusions  We found that plaque CNV tends to become larger with time, the enlargement reaching about 40% in 1 year of follow-up. The resulting loss of visual acuity, however, is not significant, and is slightly correlated with the extension of the lesion; it also does not appear to be directly related to sex.

From the Department of Ophthalmology and Visual Sciences (Drs Pece, Bolognesi, Introini, Pacelli, and Brancato) and the Epidemiology Unit (Dr Calori), Scientific Institute H San Raffaele, University of Milano, Milan, Italy.

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