Table 1.
Summary of the studies that documented the prevalence of subclinical nonexudative macular neovascularization and/or incidence of exudation.
| Author (year) | Type of study | N. eyes/Pts | Study summary | Methods used to detect MNV | Prevalence of nonexudative MNV | Incidence of exudation; follow up | Predictors/associations with exudation in subclinical NV |
|---|---|---|---|---|---|---|---|
| Palejwala et al (2015)12 | Observational, prospective | 32/32 | Patients with unilateral exudative AMD in fellow eye. | SD-OCTA, SD-OCT | 6.25% (2/32) | NA | NA |
| Choi et al (2015)8 | Observational, prospective | 12/7 | 63 eyes from 32 normal subjects and 12 eyes from 7 patients with non-exudative AMD with geographic atrophy. | SS-OCTA, SS-OCT, FA, ICGA | 16.7% (2/12) | NA | NA |
| Carnevali et al (2016)4 | Observational, prospective | 22/20 | Diagnostic tool validity assessment. | SD-OCTA, SD-OCT, FA, ICGA | NA | NA | NA |
| Roisman et al (2016)2 | Observational, prospective | 11/11 | Asymptomatic, iAMD in one eye and exudative AMD in the fellow eye. | SS-OCTA, SD-OCT, FA, ICGA | 27% (3/11) | NA | NA |
| Capuano et al (2017)10 | Observational, retrospective | 644/399 | Unilateral or bilateral geographic atrophy secondary to AMD. | SD-OCT, SD-OCTA, FA, ICGA | 11% (73/644) | 26% (5/19) by 45.7 ± 14.7 months (overall rate based on the total follow-up interval) | - In the 2 cases that developed exudation, capillaries and inner and margin loops typical of active neovascularization developed within the neovascular lesion. |
| Yanagi et al (2017)*3 | Observational, prospective | 76/76 | Patients with unilateral exudative AMD or PCV in the fellow eye. | SS-OCTA, SD-OCT, FA, ICGA | 18% (14/76) | NA | - Pachychoroid pigment epitheliopathy was the only risk factor associated with the presence of non-exudative MNV. |
| De Oliveira Dias et al (2017)**11 | Observational, prospective | 160/160 | Patients with iAMD or GA secondary to AMD in one eye and exudative AMD in the fellow eye. | SS-OCTA, SD OCT | 14.4% (23/160) | 24% by one year using Kaplan-Meier plot (cumulative, range 1–31 months) | - For eyes with subclinical MNV at the time of first OCTA imaging, the incidence of exudation was 21.1%, and for eyes without subclinical MNV, the incidence was 3.6%. - After the detection of subclinical MNV, the risk of exudation was 15.2 times greater than in eyes without subclinical MNV. |
| Treister et al (2018)***9 | Observational, retrospective | 34/34 | Patients with unilateral exudative AMD in the fellow eye. | SD-OCTA | 15% (5/34) | NA | |
| Yanagi et al (2018)*7 | Observational, prospective | 95/95 | Patients with unilateral exudative AMD or PCV in fellow eye. | SS-OCTA, SD-OCT, FA, ICGA | 19% (18/95) | 22.2% (4/18) by 6 months (overall rate based on the total follow-up interval) | - The probability of developing exudation was significantly higher in eyes with baseline non-exudative MNV (22%) compared with eyes without any MNV (2%; p<0.05). |
| Bailey et al (2019)6 | Observational, prospective | 63/63 | Patients with unilateral exudative AMD in fellow eye. | SD OCTA, SD OCT | 8% (5/63) | 80% (8/10) by 2 years (overall rate based on the total follow-up interval) | - A non-exudative MNV was associated with an 18.1-fold increase of subsequently developing exudation. |
| Heiferman et al (2019)***5 | Observational, prospective | 34/34 | Patients with unilateral exudative AMD in fellow eye. | SD OCTA, SD OCT | 15% (5/34) | 20% (1/5) by 15.2±3.27 months (overall rate based on the total follow-up interval) | - GA grew at a rate of 0.82±1.20mm2/year in four eyes without subclinical MNV and 0.02mm2/year in one eye with subclinical MNV. |
| Yang et al (2019)**1 | Observational, prospective | 227/227 | Patients with unilateral exudative AMD in fellow eye. | SS-OCTA | 13.2% (30/227) | 34.5% by 2 years using Kaplan Meier plot | - The relative risk of exudation after detection of subclinical MNV was 13.6 times greater than in the absence of subclinical MNV (P<0.001). - There was no significant risk of exudation based on lesion size alone (p=0.91). |
*, **, ***
Extensions of the previous studies (non-independent samples). Pts: patients. AMD: age-related macular degeneration. iAMD: intermediate age-related macular degeneration. OCT: optical coherence tomography angiography. OCTA: optical coherence tomography angiography. SS: swept source. SD: spectral domain. FA: fluorescein angiography. ICGA: Indocyanine green angiography. MNV: macular neovascularization. GA: geographic atrophy. PCV: polypoidal choroidal vasculopathy. NA: non-available.