Angiographic Classification of Choroidal Neovascularization Patterns in Newly Diagnosed Neovascular Age-Related Macular Degeneration and Their Relationship to Baseline Visual Acuity: A Retrospective Single-Institution Study

Background: Fundus fluorescein angiography (FA) has long served as the reference standard for identifying and classifying choroidal neovascularization (CNV) in neovascular age-related macular degeneration (AMD), distinguishing classic from occult leakage patterns that carry different prognostic and treatment implications, but institutional data describing the distribution of these angiographic patterns and their relationship to baseline visual acuity are useful for local benchmarking. Methods: We designed a retrospective, single-center study (simulated for this exercise) of patients with newly diagnosed neovascular AMD undergoing FA over a one-year period at a hypothetical retina clinic, describing the distribution of classic, occult, and minimally classic CNV patterns and their association with baseline best-corrected visual acuity. Results: In this simulated dataset (n = 298 eyes), occult CNV was the most common angiographic pattern (46.6%), followed by minimally classic (29.5%) and predominantly classic (23.9%) lesions. Mean baseline best-corrected visual acuity was worst in the predominantly classic subgroup (20/80 Snellen equivalent) and best in the occult subgroup (20/50). Conclusion: These illustrative findings are consistent with the published literature (through 2014) in supporting fluorescein angiography as a clinically important tool for classifying CNV lesion composition in neovascular AMD, with continued relevance for cases in which optical coherence tomography findings are ambiguous.