Choroideal neovascularisation in age related maculopathy and high myopia. A Laser Flare-Cell Meter study

Purpose We studied the subclinical ocular inflammation by laser flare-cell meter in patients with choroideal neovascularisation (CNV) in age related maculopathy (AMD) and in high myopia (HM). Methods We enrolled 22 patients (12 males and 10 females) without diabetes, systemic inflammatory disease or previous ocular surgery or laser therapy, aged between 65 and 89 years (mean 78,2±6,3) with macular CNV. Twelve of these patients have an age related maculopathy (AMD) and ten have an high myopia (HM). The myopia was mean -14,25 D. We made an indocyanine angiography and measured the extension of neovascularization with the Heidelberg Eye Explorer analysis program. The flare was measured with laser flare-cell meter (FM-500, Kowa, Tokio, Japan) in both eyes of the same patient. Subsequently we compared the flare data of AMD-patients that had an CNV with an area similar of the CNV of the HM-patients. Statistical analysis was performed considering significant a p<0.05. Results The flare in AMD and HM patients was 14,89±7,61 vs 8,00±0,86 photons/msec (p<0.013) and the CNV area was 4,03±2,236 vs 1,07±0,14 mm2 (p<0.001). We selected a sub-group of AMD-patients that had a CNV area similar to the CNV of HM-patients: 1.13±0.18 vs 1,07±0,14 mm2 (p<0.192) and the flare was 13,48±3,08 vs. 8,00±0,86 photons/msec (p<0.001). Conclusion Our results show that sub-clincal inflammation in AMD with CNV is higher than in HM with CNV. Furthermore in AMD the flare is correlated with CNV (p<0.021)but not in HM. These data could be explain with inflammatory pathogenesis of CNV in AMD. whereas in HM the CNV could be related to a spontaneous ruptures of the Bruch’s membrane.