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Bilateral exams warranted to detect CNV in asymptomatic fellow eyes in patients with neovascular AMD
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SAN DIEGO — The substantial incidence of asymptomatic choroidal neovascularization in the fellow eye of patients with neovascular age-related macular degeneration warrants bilateral complete retinal examination of all such patients at each visit, according to a presenter here.
Abdhish R. Bhavsar, MD, and colleagues found that in a single-surgeon series of 803 consecutive patients with neovascular AMD, CNV developed in the asymptomatic fellow eye of 50 patients (6.2%). Median age at initial presentation for treatment of the primary eye was 76 years; median age at diagnosis of CNV in the fellow eye was 79 years.
“The frequent visits required by anti-VEGF treatment provides the framework for performing ocular exams of the ipsilateral and contralateral, or fellow, eye,” Bhavsar said at the American Society of Retina Specialists annual meeting. “With frequent exams, the opportunity exists for capturing asymptomatic CNV in the fellow eye.”
However, recent changes in Centers for Medicare and Medicaid Services guidelines indicate that injections should be performed without a complete bilateral ophthalmic exam, Bhavsar said.
“Given the incidence of asymptomatic CNV in fellow eyes in this series, it would be medically indicated to perform bilateral complete ophthalmic exams, particularly including the fellow eye prior to treatment of eyes with neovascular AMD,” he said. “Since earlier treatment is typically equated with better visual acuity outcomes, treating asymptomatic eyes at the discovery of the CNV seems logical.”
Disclosure: Bhavsar has no relevant financial disclosures.