Spectral-domain optical coherence tomography features preceding new-onset neovascular membrane formation.

Objective: To determine the frequency and characteristic spectral-domain optical coherence tomography (SD-OCT) features preceding new-onset choroidal neovascularization (CNV) in the fellow eye of neovascular age-related macular degeneration (AMD) with SD-OCT.

Design: A prospective, observational study.

Participants: Sixty-eight fellow eyes of patients with unilateral CNV.

Methods: SD-OCT was performed at baseline and then monthly. The main outcome measure is the description of retinal morphology 1 month before new onset of neovascularization.

Results: During the 48-month observation period, new-onset CNV was observed in 27 fellow eyes. Several morphologic features characterized SD-OCT images ≥1 months before new onset of CNV. These included new retinal pigment epithelium defects (2 eyes), new photoreceptor defects (7 eyes), drusen touching the photoreceptor layer and the external limiting membrane (13 eyes), and new drusen (4 eyes) hyperreflective spots probably representing new growing vessels (5 eyes).

Conclusions: Monthly SD-OCT screening of fellow eyes of patients treated with anti-vascular endothelial growth factor enables identification of morphologic changes that may predispose or precede CNV formation. Rapid identification of CNV formation enhances treatment immediacy.