Asymptomatic wet AMD and Non exudative Macular Neovascularization (MNV) - Bryan Adams - 2025 03 14 скачать в хорошем качестве

Asymptomatic wet AMD and Non exudative Macular Neovascularization (MNV) - Bryan Adams - 2025 03 14

This case presentation discusses an 82-year-old female who was found to have an abnormal macula during a routine eye exam. The diagnostic workup revealed findings consistent with non-exudative macular neovascularization (MNV), including a gray-green macular lesion, pigment and lipofuscin accumulation, and parafoveal drusen with a thin double-layer sign on OCT. The differential diagnosis included age-related macular degeneration (AMD), myopic macular degeneration, central serous chorioretinopathy, vascular occlusion, and other chorioretinal diseases associated with neovascularization. The presentation emphasizes the importance of distinguishing non-exudative MNV from exudative forms, as non-exudative lesions do not show leakage on fluorescein angiography (FA) or structural OCT imaging. Emerging evidence suggests that these lesions may serve a protective role by slowing the progression of geographic atrophy (GA), though approximately 25% of cases convert to exudative disease within one to two years. The pathophysiology of MNV involves VEGF-driven angiogenesis, typically arising from the choriocapillaris, which may disrupt macular structure even without exudation. Imaging modalities such as OCTA and ICGA are critical for identifying subclinical neovascularization before fluid accumulation occurs. The presentation also highlights a shift in treatment philosophy, where suppressing MNV with anti-VEGF therapy may not always be beneficial. Instead, researchers are exploring strategies to promote the maturation and stabilization of non-leaky neovascular lesions to support retinal function while minimizing the risk of exudation. This case underscores the need for careful monitoring and individualized management strategies in patients with non-exudative MNV.