Choroidal neovascularization in eyes with choroidal vascular hyperpermeability

Invest Ophthalmol Vis Sci. 2014 Apr 29;55(5):3223-30. doi: 10.1167/iovs.14-14059.

Abstract

Purpose: We describe the clinical and genetic characteristics of choroidal neovascularization (CNV) in eyes with choroidal vascular hyperpermeability (CVH).

Methods: This cross-sectional study consisted of 438 consecutive patients who underwent fluorescein and indocyanine green angiography for macular disease. We used the genotypes of 1576 age-related macular degeneration (AMD) cases and 3248 general population controls as reference groups for genetic association analyses.

Results: Of 871 eyes (438 patients) examined, CVH was found in 227 eyes (26.1%). Of these 227 eyes, 52 (22.6%) had CNV in the macular area. The proportion of patients with drusen and the choroidal thickness were not different between eyes with and without CNV, after adjusting for age (P = 0.21 and 0.95). Of the 52 eyes with CNV, 51 had type 1 CNV and only one eye had pure type 2 CNV. Of the 51 eyes with type 1 CNV, polypoidal lesions were observed in 17 eyes (33.3%). Genotype distributions of ARMS2 (A69S) and CFH (I62V) in patients with CVH and type 1 CNV significantly differed from those of AMD cases (P = 0.0014 and 0.0098, respectively), but not from general population controls (P = 0.33 and 0.82, statistical power of 88.5% and 72.9%, respectively).

Conclusions: In patients with CVH, type 1 CNV may occur frequently and sometimes accompanies type 2 CNV or polypoidal lesions. In terms of ARMS2 and CFH, genetic background of patients with CVH and type 1 CNV was different from those with AMD, but rather similar to the general Japanese population.

Keywords: AMD; CSC; choroidal vascular hyperpermeability; genetics; type 1 CNV.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Capillary Permeability / genetics
  • Choroid / blood supply*
  • Choroid / pathology
  • Choroidal Neovascularization / diagnosis*
  • Choroidal Neovascularization / genetics
  • Choroidal Neovascularization / metabolism
  • Cross-Sectional Studies
  • DNA / genetics*
  • Female
  • Fluorescein Angiography
  • Follow-Up Studies
  • Fundus Oculi
  • Genetic Predisposition to Disease
  • Genotype
  • Humans
  • Macular Degeneration / diagnosis
  • Macular Degeneration / genetics
  • Macular Degeneration / metabolism
  • Male
  • Middle Aged
  • Ophthalmoscopy
  • Polymorphism, Genetic*
  • Proteins / genetics*
  • Proteins / metabolism
  • Retrospective Studies
  • Tomography, Optical Coherence
  • Visual Acuity

Substances

  • ARMS2 protein, human
  • Proteins
  • DNA