Incidence of choroidal neovascularisation in the fellow eye in neovascular age‐related macular degeneration patients and its correlation with type of drusen

Aims/Purpose: To study the incidence of choroidal neovascularization (CNV) in the fellow eye of patients with neovascular age‐related macular degeneration (nAMD) and its association with the presence and type of drusen.Methods: This is a retrospective study reviewing patient records' between 2018 and 2022. Forty‐four patients with newly‐diagnosed unilateral nAMD were included. All patients have been followed up for at least 4 years. The presence and type of drusen (soft, hard, pachydrusen/PED) were documented. The risk of developing nAMD in the fellow eye was estimated depending on age, gender, type of drusen, choroidal thickness and other factors.Results: The presence of soft drusen, pachydrusen/PED and hard drusen was documented in 46.4%, 25.3% and 18.9% of patients, respectively. The risk of developing CNV in fellow eye, overall, was 20.7%. In particular, the risk in any drusen group was significantly increased in comparison with the group without drusen (vs. 3.5%, p < 0.01 < 0.01, < 0.01). According to the multivariate Cox regression analysis, age (HR, 1.053; p = 0.03) and drusen type (p = 0.01) were the main risk factors. In comparison with the group without drusen, pachydrusen (HR = 18.46; p = 0.01) and soft drusen (HR = 2.41; p = 0.28) demonstrated an increased risk.Conclusions: In patients with unilateral nAMD, the incidence of developing CNV in the fellow eye is increased and depends on the type of drusen. Pachydrusen/PED was the main risk factors but soft and hard drusen increase this risk as well but to a lesser degree.