The prechoroidal cleft in neovascular age-related macular degeneration

Author(s):
Brouwer, N.J. (0000-0002-0854-0859); Vu, T.H.K.; Jong-Hesse, Y. de; Dijk, E.H.C. van (0000-0002-6351-7942)
Published
2025
Publication type
Article / Letter to editor

Abstract

The prechoroidal cleft is a lenticular, hypo-reflective space on optical coherence tomography imaging, located between a band of fibrovascular material underneath the retinal pigment epithelium (RPE) and Bruch's membrane. It occurs in 8%-22% of neovascular age-related macular degeneration (nAMD) eyes, most often with macular neovascularization (MNV) type 1 and 3, and less often with MNV type 2 or polypoidal choroidal vasculopathy. The presence of a prechoroidal cleft is associated with poor visual prognosis, some studies report more frequent occurrence of RPE tears and subretinal haemorrhages. Eyes with a prechoroidal cleft require more frequent intravitreal anti-vascular endothelial growth factor (VEGF) injections to treat the nAMD and more often require a switch to other anti-VEGF medication. Clinicians should be aware of the prechoroidal cleft for diagnostic and prognostic reasons, as it may be misunderstood for other (subretinal) fluid or even a choroidal lesion.

anti-vascular endothelial growth factorchoroidal neovascularizationclinical significanceneovascular age-related macular degenerationoptical coherence tomographyprechoroidal cleftprognosisretinal pigment epithelium detachment
Date issued
2025-11-11
Language
English
Publisher
WILEY
Is part of
Acta Ophthalmologica
hdl
1887/4298178
doi
10.1111/aos.70035