الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
 |  | from | 69 |  |  |
| | | from | 69 | | |
Abstract
Age-related macular degeneration is globally the most common cause of blindness in elderly with significant economic burden to patients and their societies. It can be dry with gradual affection of visual acuity or wet type with abrupt affection of vision. Visual outcomes of the fellow eyes of patients with unilateral wet age-related macular degeneration can be improved with regular follow-ups using optical coherence tomography and optical coherence tomography angiography to detect features of disease progression and also by home monitoring techniques.
Consecutive sampling was used in this prospective observational study aimed at detecting optical coherence tomography angiography fellow eye findings of wet age-related macular degeneration at Alexandria Main University Hospital. Supported by history taking, complete eye examination and fluorescein angiography to determine risk factors of age-related macular degeneration, the type, activity, morphology of choroidal neovascularization for the wet age-related macular degeneration also the incidence of subclinical choroidal neovascularization and its association with a double-layer sign on structural optical coherence tomography, presence or absence of flow signals and areas of signal void in the outer retinal slabs and their interpretation in the fellow eyes was done. The type of choroidal neovascularization, demographics and known consistent risk factors of age-related macular degeneration were each related to the severity of fellow eyes clinical classification of age-related macular degeneration.
Participants mean age was 71.6±7.8 years (54-89 years), most were above 70 years, slightly more men (51.8%) than females (48.2%). Hypertension, active smoking, family history of age-related macular degeneration, cataract surgery and cardiovascular diseases were noticed in 34.5%, 32.7%, 18.2%, 18.2% and 7.3% respectively. Advanced age, female sex, history of active smoking and hypertension were significantly associated with advanced fellow eye clinical findings.
Two-thirds of exudative age-related macular degeneration eyes had type I choroidal neovascularization associated with more advanced fellow eye findings than eyes with type II choroidal neovascularization. The incidence of subclinical choroidal neovascularization was 7.3%. It was detected in the outer retinal to choriocapillaris and choriocapillaris slabs of optical coherence tomography angiography and could be predicted with a double-layer sign on structural optical coherence tomography with high sensitivity and specificity. Two-thirds of eyes without subclinical choroidal neovascularization had notable areas of choriocapillaris signal void which represent shadowing artifact and/or other microvascular abnormality.
Further research with optical coherence tomography angiography may be of value in better understanding of age-related macular degeneration which can potentially allow the discovery of better therapeutic options.