Journal article
Macular morphology and visual acuity in the comparison of age-related macular degeneration treatments trials
Ophthalmology (Rochester, Minn.), Vol.120(9), pp.1860-1870
09/2013
DOI: 10.1016/j.ophtha.2013.01.073
PMCID: PMC3737287
PMID: 23642377
Abstract
To describe the effects of treatment for 1 year with ranibizumab or bevacizumab on macular morphology and the association of macular morphology with visual acuity (VA) in eyes with neovascular age-related macular degeneration (AMD). Prospective cohort study within a randomized clinical trial. Participants in the Comparison of Age-related Macular Degeneration Treatments Trials. Participants were assigned randomly to treatment with ranibizumab or bevacizumab on a monthly or as-needed schedule. Optical coherence tomography (OCT), fluorescein angiography (FA), color fundus photography (FP), and VA testing were performed periodically throughout 52 weeks. Masked readers graded images. General linear models were applied to evaluate effects of time and treatment on outcomes. Fluid type and location and thickness by OCT, size, and lesion composition on FP, FA, and VA. Intraretinal fluid (IRF), subretinal fluid (SRF), subretinal pigment epithelium fluid, and retinal, subretinal, and subretinal tissue complex thickness decreased in all treatment groups. A higher proportion of eyes treated monthly with ranibizumab had fluid resolution at 4 weeks, and the difference persisted through 52 weeks. At 52 weeks, there was little association between the presence of fluid of any type (without regard to fluid location) and the mean VA. However, at all time points, eyes with residual IRF, especially foveal IRF, had worse mean VA (9 letters) than those without IRF. Eyes with abnormally thin (<120 μm) or thick (>212 μm) retinas had worse VA than those with normal thickness (120-212 μm). At week 52, eyes with larger neovascular lesions or with foveal scar had worse VA than eyes without these features. Anti-vascular endothelial growth factor (VEGF) therapy reduced lesion activity and improved VA in all treatment groups. At all time points, eyes with residual IRF had worse VA than those without. Eyes with abnormally thin or thick retinas, residual large lesions, and scar also had worse VA. Monthly ranibizumab dosing yielded more eyes with no fluid and an abnormally thin retina, although the long-term significance is unknown. These results have important treatment implications in eyes undergoing anti-VEGF therapy for neovascular AMD. Proprietary or commercial disclosure may be found after the references.
Details
- Title: Subtitle
- Macular morphology and visual acuity in the comparison of age-related macular degeneration treatments trials
- Creators
- Glenn J Jaffe - Department of Ophthalmology, Duke University, Durham, North Carolina 27710, USA. jaffe001@mc.duke.eduDaniel F MartinCynthia A TothEbenezer DanielMaureen G MaguireGui-Shuang YingJuan E GrunwaldJiayan HuangComparison of Age-related Macular Degeneration Treatments Trials Research Group
- Contributors
- James C Folk (Contributor) - University of Iowa, Ophthalmology and Visual SciencesDouglas B Critser (Contributor) - University of Iowa, The University of Iowa Institute for Vision ResearchStephen R Russell (Contributor) - University of Iowa, Ophthalmology and Visual SciencesHeather A Stockman (Contributor) - University of Iowa, Ophthalmology and Visual Sciences
- Resource Type
- Journal article
- Publication Details
- Ophthalmology (Rochester, Minn.), Vol.120(9), pp.1860-1870
- Publisher
- United States
- DOI
- 10.1016/j.ophtha.2013.01.073
- PMID
- 23642377
- PMCID
- PMC3737287
- ISSN
- 0161-6420
- eISSN
- 1549-4713
- Grant note
- U10 EY017825 / NEI NIH HHS
- Language
- English
- Date published
- 09/2013
- Academic Unit
- The University of Iowa Institute for Vision Research; Ophthalmology and Visual Sciences
- Record Identifier
- 9983980074302771
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