Brief interpretation of the consensus nomenclature for reporting neovascular age-related macular degeneration data_Chinese Journal of Ocular Fundus Diseases

Authors：

Yang Yiliu ¹ , Yang Tingting ² , Lu Fang ¹ ,  Li Xiaoxin ³

1. Department of Ophthalmology, West China Hospital Sichuan University, Chengdu, 610041, China;
2. Editorial Department of Chinese Journal of Ocular Fundus Diseases, West China Hospital Sichuan University, Chengdu, 610041, China;
3. Xiamen Ophthalmic Center, Xiamen University, Xiamen 361003, China;
Fang and Li Xiaoxin are contributed equally to the article;

Corresponding author：

Li Xiaoxin, Email: dr_lixiaoxin@163.com

Keywords：

Wet macular degeneration; Neovascularization, pathologic; Consensus; Interpretation

DOI：

10.3760/cma.j.cn511434-20220128-00055

Video：

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With the rapid development of fundus imaging technology, it is of great significance to establish a new naming system for neovascular age-related macular degeneration (nAMD) based on the multi-mode imaging. In 2020, an international panel of retina specialists, imaging and image reading center experts, and ocular pathologists reached a consensus after repeated discussions, a new name for nAMD subtype and related lesions was established based on the previous knowledge of fundus fluorescein angiography and pathology, combining indocyanine green angiography, optical coherence tomography and optical coherence tomography angiography with current pathological knowledge, in order to help ophthalmologists to study nAMD. The consensus proposed the term "macular neovascularization" and classified it into type 1, type 2 and type 3. Many lesions related to macular neovascularization, such as pigment epithelial detachment, hemorrhage, fibrosis, rip of retinal pigment epithelium and so on, were named. The new designation will help improve clinical communication between different studies, establish standard definitions and terms between reading centers and researchers, and further promote the understanding and communication of nAMD among ophthalmologists.

Citation： Yang Yiliu, Yang Tingting, Lu Fang, Li Xiaoxin. Brief interpretation of the consensus nomenclature for reporting neovascular age-related macular degeneration data. Chinese Journal of Ocular Fundus Diseases, 2022, 38(2): 99-107. doi: 10.3760/cma.j.cn511434-20220128-00055 Copy

1.	Gass JD. Pathogenesis of disciform detachment of the neuroepithelium[J]. Am J Ophthalmol, 1967, 63(3): S1-S139.
2.	Gass JD. Drusen and disciform macular detachment and degeneration[J]. Trans Am Ophthalmol Soc, 1972, 70: 409-436.
3.	Gass JDM. Stereoscopic atlas of macular diseases: a funduscopic and angiographic presentation[M]. St. Louis: Mosby, 1970.
4.	Blair CJ. Geographic atrophy of the retinal pigment epithelium. A manifestation of senile macular degeneration[J]. Arch Ophthalmol, 1975, 93(1): 19-25. DOI: 10.1001/archopht.1975.01010020023003.
5.	Spaide RF, Jaffe GJ, Sarraf D, et al. Consensus nomenclature for reporting neovascular age-related macular degeneration data[J]. Ophthalmology, 2020, 127(5): 616-636. DOI: 10.1016/j.ophtha.2019.11.004.
6.	Sarks S, Cherepanoff S, Killingsworth M, et al. Relationship of basal laminar deposit and membranous debris to the clinical presentation of early age-related macular degeneration[J]. Invest Ophthalmol Vis Sci, 2007, 48(3): 968-977. DOI: 10.1167/iovs.06-0443.
7.	Srivastava SK, Csaky KG. Identifification of well-defifined intrachoroidal neovascularization by high-speed indocyanine green angiography[J]. Retina, 2003, 23(5): 712-714. DOI: 10.1097/00006982-200310000-00019.
8.	Yannuzzi LA, Slakter JS, Sorenson JA, et al. Digital indocyanine green videoangiography and choroidal neovascularization[J]. Retina, 1992, 12(3): 191-223. DOI: 10.1097/00006982-199212030-00003.
9.	Sarks SH. New vessel formation beneath the retinal pigment epithelium in senile eyes[J]. Br J Ophthalmol, 1973, 57(12): 951-965. DOI: 10.1136/bjo.57.12.951.
10.	Gass JDM. Stereoscopic atlas of macular diseases: diagnosis and treatment[M]. 3rd ed. St. Louis: C. V. Mosby Company, 1987.
11.	Hanutsaha P, Guyer DR, Yannuzzi LA, et al. Indocyaninegreen videoangiography of drusen as a possible predictive indicator of exudative maculopathy[J]. Ophthalmology, 1998, 105(9): 1632-1636. DOI: 10.1016/S0161-6420(98)99030-3.
12.	de Oliveira Dias JR, Zhang Q, Garcia JMB, et al. Natural history of subclinical neovascularization in nonexudative age related macular degeneration using swept-source OCT angiography[J]. Ophthalmology, 2018, 125(2): 255-266. DOI: 10.1016/j.ophtha.2017.08.030.
13.	Amissah-Arthur KN, Panneerselvam S, Narendran N, et al. Optical coherence tomography changes before the development of choroidal neovascularization in second eyes of patients with bilateral wet macular degeneration[J]. Eye (Lond), 2012, 26(3): 394-399. DOI: 10.1038/eye.2011.335.
14.	Querques G, Srour M, Massamba N, et al. Functional characterization and multimodal imaging of treatment-naive “quiescent” choroidal neovascularization[J]. Invest Ophthalmol Vis Sci, 2013, 54(10): 6886-6892. DOI: 10.1167/iovs.13-11665.
15.	Yannuzzi LA, Sorenson J, Spaide RF, et al. Idiopathic polypoidal choroidal vasculopathy (IPCV)[J]. Retina, 1990, 10(1): 1-8. DOI: 10.1097/00006982-199010010-00001.
16.	Wong CW, Wong TY, Cheung CM. Polypoidal choroidal vasculopathy in Asians[J]. J Clin Med, 2015, 4(5): 782-821. DOI: 10.3390/jcm4050782.
17.	Cheung CMG, Lai TYY, Ruamviboonsuk P, et al. Polypoidal choroidal vasculopathy: defifinition, pathogenesis, diagnosis, and management[J]. Ophthalmology, 2018, 125(5): 708-724. DOI: 10.1016/j.ophtha.2017.11.019.
18.	Sho K, Takahashi K, Yamada H, et al. Polypoidal choroidal vasculopathy: incidence, demographic features, and clinical characteristics[J]. Arch Ophthalmol, 2003, 121(10): 1392-1396. DOI: 10.1001/archopht.121.10.1392.
19.	Spaide RF, Yannuzzi LA, Slakter JS, et al. Indocyanine green videoangiography of idiopathic polypoidal choroidal vasculopathy[J]. Retina, 1995, 15(2): 100-110. DOI: 10.1097/00006982-199515020-00003.
20.	MacCumber MW, Dastgheib K, Bressler NM, et al. Clinicopathologic correlation of the multiple recurrent serosanguineous retinal pigment epithelial detachments syndrome[J]. Retina, 1994, 14(2): 143-152. DOI: 10.1097/00006982-199414020-00007.
21.	Spraul CW, Grossniklaus HE, Lang GK. Idiopathische polypöse choroidale vaskulopathie (IPCV) [Idiopathic polypoid choroid vasculopathy][J]. Klin Monatsbl Augenheilkd, 1997, 210(6): 405-406. DOI: 10.1055/s-2008-1035085.
22.	Rosa RH Jr, Davis JL, Eifrig CW. Clinicopathologic reports, case reports, and small case series: clinicopathologic correlation of idiopathic polypoidal choroidal vasculopathy[J]. Arch Ophthalmol, 2002, 120(4): 502-508. DOI: 10.1001/archopht.120.4.502.
23.	Dansingani KK, Gal-Or O, Sadda SR, et al. Understanding aneurysmal type 1 neovascularization (polypoidal choroidal vasculopathy): a lesson in the taxonomy of expanded spectra’da review[J]. Clin Exp Ophthalmol, 2018, 46(2): 189-200. DOI: 10.1111/ceo.13114.
24.	Hartnett ME, Weiter JJ, Staurenghi G, et al. Deep retinal vascular anomalous complexes in advanced age-related macular degeneration[J]. Ophthalmology, 1996, 103(12): 2042-2053. DOI: 10.1016/s0161-6420(96)30389-8.
25.	Yannuzzi LA, Negrão S, Iida T, et al. Retinal angiomatous proliferation in age-related macular degeneration[J]. Retina, 2001, 21(5): 416-434. DOI: 10.1097/iae.0b013e31823f9b3b.
26.	Gass JD, Agarwal A, Lavina AM, et al. Focal inner retinal hemorrhages in patients with drusen: an early sign of occult choroidal neovascularization and chorioretinal anastomosis[J]. Retina, 2003, 23(6): 741-751. DOI: 10.1097/00006982-200312000-00001.
27.	Coscas F, Querques G, Forte R, et al. Combined flfluorescein angiography and spectral-domain optical coherence tomography imaging of classic choroidal neovascularization secondary to age-related macular degeneration before and after intravitreal ranibizumab injections[J]. Retina, 2012, 32(6): 1069-1076. DOI: 10.1097/IAE.0b013e318240a529.
28.	Ristau T, Keane PA, Walsh AC, et al. Relationship between visual acuity and spectral domain optical coherence tomography retinal parameters in neovascular age-related macular degeneration[J]. Ophthalmologica, 2014, 231(1): 37-44. DOI: 10.1159/000354551.
29.	Shah VP, Shah SA, Mrejen S, et al. Subretinal hyperreflflective exudation associated with neovascular age-related macular degeneration[J]. Retina, 2014, 34(7): 1281-1288. DOI: 10.1097/IAE.0000000000000166.
30.	Ores R, Puche N, Querques G, et al. Gray hyper-reflflective subretinal exudative lesions in exudative age-related macular degeneration[J]. Am J Ophthalmol, 2014, 158(2): 354-361. DOI: 10.1016/j.ajo.2014.04.025.
31.	Yannuzzi LA, Hope-Ross M, Slakter JS, et al. Analysis of vascularized pigment epithelial detachments using indocyanine green videoangiography[J]. Retina, 1994, 14(2): 99-113. DOI: 10.1097/00006982-199414020-00003.
32.	Cukras C, Agrón E, Klein ML, et al. Natural history of drusenoid pigment epithelial detachment in age-related macular degeneration: age-related eye disease study report no. 28[J]. Ophthalmology, 2010, 117(3): 489-499. DOI: 10.1016/j.ophtha.2009.12.002.
33.	Casalino G, Stevenson MR, Bandello F, et al. Tomographic biomarkers predicting progression to fifibrosis in treated neovascular age-related macular degeneration: a multimodal imaging study[J]. Ophthalmol Retina, 2018, 2(5): 451-461. DOI: 10.1016/j.oret.2017.08.019.
34.	Schlingemann RO. Role of growth factors and the wound healing response in age-related macular degeneration[J]. Graefe's Arch Clin Exp Ophthalmol, 2004, 242(1): 91-101. DOI: 10.1007/s00417-003-0828-0.
35.	Kuiper EJ, Van Nieuwenhoven FA, de Smet MD, et al. The angio-fifibrotic switch of VEGF and CTGF in proliferative diabetic retinopathy[J/OL]. PLoS One, 2008, 3(7): e2675[2008-07-16].https://pubmed.ncbi.nlm.nih.gov/18628999/. DOI: 10.1371/journal.pone.0002675.
36.	Spaide RF. Enhanced depth imaging optical coherence tomography of retinal pigment epithelial detachment in agerelated macular degeneration[J]. Am J Ophthalmol, 2009, 147(4): 644-652. DOI: 10.1016/j.ajo.2008.10.005.
37.	Spaide RF. Choroidal imaging with optical coherence tomography[M]//Holz FG, Spaide RF. Medical retina: a focus on imaging. New York: Springer, 2010: 169-190.
38.	Sikorav A, Semoun O, Zweifel S, et al. Prevalence and quantifification of geographic atrophy associated with newly diagnosed and treatment-naïve exudative age-related macular degeneration[J]. Br J Ophthalmol, 2017, 101(4): 438-444. DOI: 10.1136/bjophthalmol-2015-308065.
39.	Klein R, Davis MD, Magli YL, et al. The Wisconsin age related maculopathy grading system[J]. Ophthalmology, 1991, 98(7): 1128-1134. DOI: 10.1016/s0161-6420(91)32186-9.
40.	Domalpally A, Danis RP, Trane R, et al. Atrophy in neovascular age-related macular degeneration: age-related eye disease study 2 report number 15[J]. Ophthalmol Retina, 2018, 2(10): 1021-1027. DOI: 10.1016/j.oret.2018.04.009.
41.	Spaide RF. Outer retinal atrophy after regression of subretinal drusenoid deposits as a newly recognized form of late agerelated macular degeneration[J]. Retina, 2013, 33(9): 1800-1808. DOI: 10.1097/IAE.0b013e31829c3765.

1. Gass JD. Pathogenesis of disciform detachment of the neuroepithelium[J]. Am J Ophthalmol, 1967, 63(3): S1-S139.
2. Gass JD. Drusen and disciform macular detachment and degeneration[J]. Trans Am Ophthalmol Soc, 1972, 70: 409-436.
3. Gass JDM. Stereoscopic atlas of macular diseases: a funduscopic and angiographic presentation[M]. St. Louis: Mosby, 1970.
4. Blair CJ. Geographic atrophy of the retinal pigment epithelium. A manifestation of senile macular degeneration[J]. Arch Ophthalmol, 1975, 93(1): 19-25. DOI: 10.1001/archopht.1975.01010020023003.
5. Spaide RF, Jaffe GJ, Sarraf D, et al. Consensus nomenclature for reporting neovascular age-related macular degeneration data[J]. Ophthalmology, 2020, 127(5): 616-636. DOI: 10.1016/j.ophtha.2019.11.004.
6. Sarks S, Cherepanoff S, Killingsworth M, et al. Relationship of basal laminar deposit and membranous debris to the clinical presentation of early age-related macular degeneration[J]. Invest Ophthalmol Vis Sci, 2007, 48(3): 968-977. DOI: 10.1167/iovs.06-0443.
7. Srivastava SK, Csaky KG. Identifification of well-defifined intrachoroidal neovascularization by high-speed indocyanine green angiography[J]. Retina, 2003, 23(5): 712-714. DOI: 10.1097/00006982-200310000-00019.
8. Yannuzzi LA, Slakter JS, Sorenson JA, et al. Digital indocyanine green videoangiography and choroidal neovascularization[J]. Retina, 1992, 12(3): 191-223. DOI: 10.1097/00006982-199212030-00003.
9. Sarks SH. New vessel formation beneath the retinal pigment epithelium in senile eyes[J]. Br J Ophthalmol, 1973, 57(12): 951-965. DOI: 10.1136/bjo.57.12.951.
10. Gass JDM. Stereoscopic atlas of macular diseases: diagnosis and treatment[M]. 3rd ed. St. Louis: C. V. Mosby Company, 1987.
11. Hanutsaha P, Guyer DR, Yannuzzi LA, et al. Indocyaninegreen videoangiography of drusen as a possible predictive indicator of exudative maculopathy[J]. Ophthalmology, 1998, 105(9): 1632-1636. DOI: 10.1016/S0161-6420(98)99030-3.
12. de Oliveira Dias JR, Zhang Q, Garcia JMB, et al. Natural history of subclinical neovascularization in nonexudative age related macular degeneration using swept-source OCT angiography[J]. Ophthalmology, 2018, 125(2): 255-266. DOI: 10.1016/j.ophtha.2017.08.030.
13. Amissah-Arthur KN, Panneerselvam S, Narendran N, et al. Optical coherence tomography changes before the development of choroidal neovascularization in second eyes of patients with bilateral wet macular degeneration[J]. Eye (Lond), 2012, 26(3): 394-399. DOI: 10.1038/eye.2011.335.
14. Querques G, Srour M, Massamba N, et al. Functional characterization and multimodal imaging of treatment-naive “quiescent” choroidal neovascularization[J]. Invest Ophthalmol Vis Sci, 2013, 54(10): 6886-6892. DOI: 10.1167/iovs.13-11665.
15. Yannuzzi LA, Sorenson J, Spaide RF, et al. Idiopathic polypoidal choroidal vasculopathy (IPCV)[J]. Retina, 1990, 10(1): 1-8. DOI: 10.1097/00006982-199010010-00001.
16. Wong CW, Wong TY, Cheung CM. Polypoidal choroidal vasculopathy in Asians[J]. J Clin Med, 2015, 4(5): 782-821. DOI: 10.3390/jcm4050782.
17. Cheung CMG, Lai TYY, Ruamviboonsuk P, et al. Polypoidal choroidal vasculopathy: defifinition, pathogenesis, diagnosis, and management[J]. Ophthalmology, 2018, 125(5): 708-724. DOI: 10.1016/j.ophtha.2017.11.019.
18. Sho K, Takahashi K, Yamada H, et al. Polypoidal choroidal vasculopathy: incidence, demographic features, and clinical characteristics[J]. Arch Ophthalmol, 2003, 121(10): 1392-1396. DOI: 10.1001/archopht.121.10.1392.
19. Spaide RF, Yannuzzi LA, Slakter JS, et al. Indocyanine green videoangiography of idiopathic polypoidal choroidal vasculopathy[J]. Retina, 1995, 15(2): 100-110. DOI: 10.1097/00006982-199515020-00003.
20. MacCumber MW, Dastgheib K, Bressler NM, et al. Clinicopathologic correlation of the multiple recurrent serosanguineous retinal pigment epithelial detachments syndrome[J]. Retina, 1994, 14(2): 143-152. DOI: 10.1097/00006982-199414020-00007.
21. Spraul CW, Grossniklaus HE, Lang GK. Idiopathische polypöse choroidale vaskulopathie (IPCV) [Idiopathic polypoid choroid vasculopathy][J]. Klin Monatsbl Augenheilkd, 1997, 210(6): 405-406. DOI: 10.1055/s-2008-1035085.
22. Rosa RH Jr, Davis JL, Eifrig CW. Clinicopathologic reports, case reports, and small case series: clinicopathologic correlation of idiopathic polypoidal choroidal vasculopathy[J]. Arch Ophthalmol, 2002, 120(4): 502-508. DOI: 10.1001/archopht.120.4.502.
23. Dansingani KK, Gal-Or O, Sadda SR, et al. Understanding aneurysmal type 1 neovascularization (polypoidal choroidal vasculopathy): a lesson in the taxonomy of expanded spectra’da review[J]. Clin Exp Ophthalmol, 2018, 46(2): 189-200. DOI: 10.1111/ceo.13114.
24. Hartnett ME, Weiter JJ, Staurenghi G, et al. Deep retinal vascular anomalous complexes in advanced age-related macular degeneration[J]. Ophthalmology, 1996, 103(12): 2042-2053. DOI: 10.1016/s0161-6420(96)30389-8.
25. Yannuzzi LA, Negrão S, Iida T, et al. Retinal angiomatous proliferation in age-related macular degeneration[J]. Retina, 2001, 21(5): 416-434. DOI: 10.1097/iae.0b013e31823f9b3b.
26. Gass JD, Agarwal A, Lavina AM, et al. Focal inner retinal hemorrhages in patients with drusen: an early sign of occult choroidal neovascularization and chorioretinal anastomosis[J]. Retina, 2003, 23(6): 741-751. DOI: 10.1097/00006982-200312000-00001.
27. Coscas F, Querques G, Forte R, et al. Combined flfluorescein angiography and spectral-domain optical coherence tomography imaging of classic choroidal neovascularization secondary to age-related macular degeneration before and after intravitreal ranibizumab injections[J]. Retina, 2012, 32(6): 1069-1076. DOI: 10.1097/IAE.0b013e318240a529.
28. Ristau T, Keane PA, Walsh AC, et al. Relationship between visual acuity and spectral domain optical coherence tomography retinal parameters in neovascular age-related macular degeneration[J]. Ophthalmologica, 2014, 231(1): 37-44. DOI: 10.1159/000354551.
29. Shah VP, Shah SA, Mrejen S, et al. Subretinal hyperreflflective exudation associated with neovascular age-related macular degeneration[J]. Retina, 2014, 34(7): 1281-1288. DOI: 10.1097/IAE.0000000000000166.
30. Ores R, Puche N, Querques G, et al. Gray hyper-reflflective subretinal exudative lesions in exudative age-related macular degeneration[J]. Am J Ophthalmol, 2014, 158(2): 354-361. DOI: 10.1016/j.ajo.2014.04.025.
31. Yannuzzi LA, Hope-Ross M, Slakter JS, et al. Analysis of vascularized pigment epithelial detachments using indocyanine green videoangiography[J]. Retina, 1994, 14(2): 99-113. DOI: 10.1097/00006982-199414020-00003.
32. Cukras C, Agrón E, Klein ML, et al. Natural history of drusenoid pigment epithelial detachment in age-related macular degeneration: age-related eye disease study report no. 28[J]. Ophthalmology, 2010, 117(3): 489-499. DOI: 10.1016/j.ophtha.2009.12.002.
33. Casalino G, Stevenson MR, Bandello F, et al. Tomographic biomarkers predicting progression to fifibrosis in treated neovascular age-related macular degeneration: a multimodal imaging study[J]. Ophthalmol Retina, 2018, 2(5): 451-461. DOI: 10.1016/j.oret.2017.08.019.
34. Schlingemann RO. Role of growth factors and the wound healing response in age-related macular degeneration[J]. Graefe's Arch Clin Exp Ophthalmol, 2004, 242(1): 91-101. DOI: 10.1007/s00417-003-0828-0.
35. Kuiper EJ, Van Nieuwenhoven FA, de Smet MD, et al. The angio-fifibrotic switch of VEGF and CTGF in proliferative diabetic retinopathy[J/OL]. PLoS One, 2008, 3(7): e2675[2008-07-16].https://pubmed.ncbi.nlm.nih.gov/18628999/. DOI: 10.1371/journal.pone.0002675.
36. Spaide RF. Enhanced depth imaging optical coherence tomography of retinal pigment epithelial detachment in agerelated macular degeneration[J]. Am J Ophthalmol, 2009, 147(4): 644-652. DOI: 10.1016/j.ajo.2008.10.005.
37. Spaide RF. Choroidal imaging with optical coherence tomography[M]//Holz FG, Spaide RF. Medical retina: a focus on imaging. New York: Springer, 2010: 169-190.
38. Sikorav A, Semoun O, Zweifel S, et al. Prevalence and quantifification of geographic atrophy associated with newly diagnosed and treatment-naïve exudative age-related macular degeneration[J]. Br J Ophthalmol, 2017, 101(4): 438-444. DOI: 10.1136/bjophthalmol-2015-308065.
39. Klein R, Davis MD, Magli YL, et al. The Wisconsin age related maculopathy grading system[J]. Ophthalmology, 1991, 98(7): 1128-1134. DOI: 10.1016/s0161-6420(91)32186-9.
40. Domalpally A, Danis RP, Trane R, et al. Atrophy in neovascular age-related macular degeneration: age-related eye disease study 2 report number 15[J]. Ophthalmol Retina, 2018, 2(10): 1021-1027. DOI: 10.1016/j.oret.2018.04.009.
41. Spaide RF. Outer retinal atrophy after regression of subretinal drusenoid deposits as a newly recognized form of late agerelated macular degeneration[J]. Retina, 2013, 33(9): 1800-1808. DOI: 10.1097/IAE.0b013e31829c3765.

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Brief interpretation of the consensus nomenclature for reporting neovascular age-related macular degeneration data

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