Patients with wet AMD in one eye may exhibit unique features in their fellow nonexudative eye, and these different ocular and systemic characteristics may be associated with progression to exudation, a new study in Ophthalmology reports. The research team from Singapore and the UK also found more than a third of study eyes with nonexudative neovascularization at baseline progressed to exudation. Using OCT-A imaging, the authors observed a link between exudation and study eyes that had larger baseline lesion size and increase in vessel density and vessel length density.¹

Because nearly 40% of eyes progressed to exudation, close monitoring is important, and based on the simple severity scale, almost all eyes will have converted around 10 years after the initial eye converted, according to Raza M. Shah, MD, who summarized the investigation’s findings in Practice Update.²

The study enrolled 229 study eyes. Patients with nAMD in one eye were eligible for inclusion. The study eye was the fellow eye that was free of nAMD with a minimum one-year follow-up.¹

Among the study eyes, 21 (9%) had nonexudative neovascularization detected on OCT-A at baseline. Hyperlipidemia, triglycerides and baseline lesion size in the presenting eye were significantly tied to nonexudative neovascularization in the study eye, the researchers noted.¹

In the study eye group, eight (38%) progressed to exudation at roughly 377 days. Specifically, eyes that progressed had larger baseline neovascularization size (1,834μm vs. 910μm), a higher increase in vessel density per year (8.3% vs. 1.1%) and a higher increase in vessel length density per year (15.6% vs. 1.9%). The change in lesion size per year was similar in both groups, the researchers noted.¹

Also in Practice Update, Leonard J. Press, OD, commented, “Being aware of the temporal characteristics of eyes with nonexudative nAMD can be of prognostic importance, as well as temper the frequency of monitoring.”²