Risk Factors for Choroidal Neovascularization in the Second Eye of Patients With Juxtafoveal or Subfoveal Choroidal Neovascularization Secondary to Age-Related Macular Degeneration
- 1 June 1997
- journal article
- clinical trial
- Published by American Medical Association (AMA) in American Journal of Ophthalmology
- Vol. 115 (6), 741-747
- https://doi.org/10.1001/archopht.1997.01100150743009
Abstract
Objectives: To verify and quantify previously reported risk factors for development of choroidal neovascularization (CNV) in the fellow eye of patients with 1 eye affected with CNV secondary to age-related macular degeneration, to examine the value of characteristics of the pericentral macula in the quantification of risk for developing CNV, and to explore whether the presence of occult CNV in the first eye affects the development of CNV in the fellow eye. Design, Patients, and Setting: Follow-up study of fellow eyes of 670 patients enrolled in multicenter, randomized clinical trials of laser photocoagulation of juxtafoveal or subfoveal CNV. Main Outcome Measure: Development of CNV. Results: Three characteristics of the central macula of the fellow eye and 1 systemic factor were associated independently with an increased risk of developing CNV: the presence of 5 or more drusen (relative risk, 2.1; 95% confidence interval,1.3-3.5), focal hyperpigmentation (relative risk, 2.0; 95% confidence interval, 1.4-2.9), 1 or more large drusen (relative risk, 1.5; 95% condfidence interval 1.0-2.2), and definite systemic hypertension (relative risk, 1.7; 95% confidence interval, 1.2-2.4). Estimated 5-year incidence rates ranged from 7% for the subgroup with no risk factors to 87% for the subgroup with all 4 risk factors. Characteristics of the pericentral macula were not strongly associated with the development of CNV. The presence of occult CNV in the first eye affected had no influence on the development of CNV or on the type of CNV in the fellow eye. Conclusions: The prognosis of the fellow eye is affected strongly by characteristics of its central macula and by systemic hypertension. These factors should be considered when counseling patients with unilateral neovascular age-related macular degeneration and when targeting patients for preventive interventions.Keywords
This publication has 18 references indexed in Scilit:
- Epidemiology of Age-related MaculopathyEpidemiologic Reviews, 1995
- Relationship of Drusen and Abnormalities of the Retinal Pigment Epithelium to the Prognosis of Neovascular Macular DegenerationAmerican Journal of Ophthalmology, 1990
- Oral Zinc in Macular DegenerationAmerican Journal of Ophthalmology, 1988
- Systemic Hypertension and Age-Related Maculopathy in the Framingham StudyAmerican Journal of Ophthalmology, 1986
- SENILE MACULAR DEGENERATION: A CASE-CONTROL STUDYAmerican Journal of Epidemiology, 1983
- The Second Eye of Patients With Senile Macular DegenerationAmerican Journal of Ophthalmology, 1983
- Senile macular changes in the black African.British Journal of Ophthalmology, 1978
- Senile disciform macular degeneration in the second eye.British Journal of Ophthalmology, 1977
- Natural History Of Disciform Degeneration Of The MaculaAmerican Journal of Ophthalmology, 1974
- Drusen and Disciform Macular Detachment and DegenerationAmerican Journal of Ophthalmology, 1973