Neovascularization May Protect Against Macular Atrophy Progression

Final Stage Of Senile Macular Degeneration: Macular Atrophy. Photograph Of The Back Of Eye. (Photo By BSIP/UIG Via Getty Images)
Although neovascularization appears to protect against the progression of macular atrophy, it is unclear whether this protection persists in the long term.

Macular neovascularization (MVN) may have a protective effect against the progression of macular atrophy (MA) in patients with age-related macular degeneration (AMD), according to research published in Ophthalmology Retina. 

Researchers conducted a retrospective, longitudinal comparative case series of 117 eyes of 95 patients (mean age 77.8±10.18 years, 73.68% women) with AMD. The cohort consisted of individuals with geographic atrophy (GA) (n=61) or MA with MNV (n=56). Among the MA cohort, 50% had type 1 MNV, 12.5% had type 2 MNV, and 37.5% had type 3 MNV. 

The team performed fundus autofluorescence, near infrared reflectance, and optical coherence tomography (OCT) imaging on all participants at baseline and at follow-up visits every 6±3 months for 2 years, and 12±3 months thereafter for a period of 5 years to calculate atrophy growth rates.  

The investigators observed similar baseline lesion sizes in both cohorts (1.74 vs 1.53 mm2, P =.56). However, they noted greater overall enlargement rates and area of atrophy growth in the GA cohort at 5 year follow-up compared with the MA arm (1.72 vs 1.32 mm2/year, P =.002 and +8.06 vs +4.55 mm2, P =.001, respectively).

The researchers attribute their findings to a protective effect of MNV against the expansion of MA, but admit “it is unclear whether these benefits are sustained in the long-term.”

Study limitations include a single center design, a retrospective nature, and a lack of OCT-angiography images at each follow-up visit. 

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or clinical research organizations. Please see the original reference for a full list of disclosures.


Airaldi M, Corvi F, Cozzi M, Nittala MG, Staurenghi G, Sadda SR. Differences in long-term progression of atrophy between neovascular and non-neovascular age-related macular degeneration. Ophthalmol Retina. Published online April 20, 2022. doi:10.1016/j.oret.2022.04.012