The results of a recent study suggest choroidal neovascularization (CNV) may actually protect certain parts of the retina from AMD progression. A team of researchers in Germany  noted markedly reduced retinal pigment epithelium (RPE) atrophy progression in areas that were co-localizing with type 1 CNV, pointing to a potential protective effect of type 1 CNV on the RPE and overlying neurosensory retina.

This two-part series of non-interventional, prospective studies evaluated 98 eyes of 59 patients diagnosed with AMD. Eyes were divided into three categories based on multimodal imaging and ocular history: RPE atrophy with treatment-naïve quiescent CNV, RPE atrophy with a history of exudative CNV and RPE atrophy without evidence of co-existing CNV.

The researchers imaged RPE atrophy with serial fundus-autofluorescence and infrared-reflectance images and matched any co-existing CNV based on location and dimensions. They then created a model based on these findings to predict current and future RPE atrophy.

Their prediction model was highly accurate and achieved significant overlap between the predicted and observed RPE atrophy progression. The team found that the odds for future RPE atrophy involvement were reduced by a factor of 0.21 in the presence of treatment-naïve quiescent type 1 CNV and by a factor of 0.46 in the presence of exudative type 1 CNV.

“These results may have relevant clinical implications for the management of CNV and may further lead to new therapeutic strategies to prevent atrophy progression,” the study authors concluded in their paper.

Pfau M, Möller PT, Künzel SH, et al. Type-1 choroidal neovascularization is associated with reduced localized progression of atrophy in age-related macular degeneration. Ophthalmology. October 1, 2019. [Epub ahead of print].