Nascent Geographic Atrophy as a Predictor of Type 3 Macular Neovascularization Development

Riccardo Sacconi, David Sarraf, Srini Vas R. Sadda, K. Bailey Freund, Andrea Servillo, Meira Miri Fogel Levin, Eliana Costanzo, Giulia Corradetti, Diogo Cabral, Dinah Zur, Omer Trivizki, Mariacristina Parravano, Francesco Bandello, Anat Loewenstein, Giuseppe Querques*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Purpose: To investigate the association of nascent geographic atrophy (GA) preceding the development of exudative type 3 macular neovascularization (MNV) in patients with age-related macular degeneration (AMD). Design: Retrospective longitudinal study. Participants: Patients with AMD diagnosed with treatment-naive exudative type 3 MNV in 1 or both eyes were evaluated. Inclusion criteria included serial tracked structural OCT examinations for ≥ 2 years before the detection of exudative type 3 MNV. Methods: Clinical characteristics and retinal imaging, including structural OCT at baseline and at each follow-up examination, were analyzed. Eyes showing the presence of nascent GA during the follow-up were selected for analysis of prevalence, and clinical characteristics at the site of subsequent type 3 MNV development. Main Outcome Measures: Description of the prevalence and clinical characteristics of nascent GA at the site of subsequent type 3 MNV development. Results: Overall, 97 eyes affected by type 3 MNV meeting inclusion criteria were analyzed. Of 97 eyes (71 patients), 22 eyes of 21 patients (mean age 82 ± 9 years) showed nascent GA preceding exudative type 3 MNV. The observed prevalence of nascent GA preceding exudative type 3 MNV was 22.7% (95% confidence interval, 14.4%–31.0%). Exudative type 3 MNV developed a mean of 9 ± 6 months after detection of nascent GA. The presence of reticular pseudodrusen in the study eye did not significantly influence the timing of exudative type 3 MNV development after the observation of nascent GA (P > 0.1 in all analyses). Reduced best-corrected visual acuity was recorded at the exudative type 3 stage in comparison with the nascent GA stage (P = 0.003). Conclusions: As nascent GA may precede the development of exudative type 3 MNV, the detection of nascent GA in eyes with AMD may warrant closer surveillance to identify early exudative type 3 MNV warranting treatment. Financial Disclosure(s): Proprietary or commercial disclosure may be found after the references.

Original languageEnglish
Pages (from-to)586-592
Number of pages7
JournalOphthalmology Retina
Issue number7
StatePublished - Jul 2023


  • Age-related macular degeneration
  • Geographic atrophy
  • Nascent GA
  • Nascent type 3
  • Type 3 neovascularization


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