Outer retinal tubulation in the comparison of age-related macular degeneration treatments trials (CATT)

Joo Yong Lee; Francisco A Folgar; Maureen G Maguire; Gui-shuang Ying; Cynthia A Toth; Daniel F Martin; Glenn J Jaffe; CATT Research Group

doi:10.1016/j.ophtha.2014.06.013

Back

Outer retinal tubulation in the comparison of age-related macular degeneration treatments trials (CATT)

Journal article

Peer reviewed

Outer retinal tubulation in the comparison of age-related macular degeneration treatments trials (CATT)

Joo Yong Lee, Francisco A Folgar, Maureen G Maguire, Gui-shuang Ying, Cynthia A Toth, Daniel F Martin, Glenn J Jaffe and CATT Research Group

Ophthalmology (Rochester, Minn.), Vol.121(12), pp.2423-2431

12/2014

DOI: 10.1016/j.ophtha.2014.06.013

PMCID: PMC4254295

PMID: 25064723

Files and links (1)

url

http://doi.org/10.1016/j.ophtha.2014.06.013View

Open Access

Abstract

To determine the prevalence of, risk factors for, and visual acuity (VA) correlations with outer retinal tubulation (ORT) seen on spectral-domain optical coherence tomography (SD OCT) in eyes with neovascular age-related macular degeneration (AMD) after anti-vascular endothelial growth factor (VEGF) therapy. Prospective cohort study within a randomized clinical trial. Patients with SD OCT images at weeks 56 and 104 in the Comparison of AMD Treatments Trials (CATT). Participants in the CATT were assigned randomly to ranibizumab (0.5 mg) or bevacizumab (1.25 mg) treatment and to a monthly or pro re nata (PRN) injection-dosing regimen. A subset of eyes was imaged with SD OCT beginning at week 56. Cirrus 512×128 or Spectralis 20°×20° volume cube scan protocols were used to acquire SD OCT images. Two independent readers at the CATT OCT reading center graded scans, and a senior reader arbitrated discrepant grades. The prevalence of ORT, identified as tubular structures seen on at least 3 consecutive Cirrus B scans or 2 consecutive Spectralis B scans, was determined. The associations of patient-specific and ocular features at baseline and follow-up with ORT were evaluated by univariate and multivariate analyses. Outer retinal tubulations. Seven of 69 eyes (10.1%) at 56 weeks and 64 of 368 eyes (17.4%) at week 104 had ORTs. Absence of diabetes, poor VA, blocked fluorescence, geographic atrophy, greater lesion size, and presence of subretinal hyperreflective material at baseline were associated independently with greater risk of ORT at 104 weeks (P < 0.05). Neither drug nor dosing regimen were associated significantly with ORT. The mean VA of eyes with ORT at week 104 (58.5 Early Treatment Diabetic Retinopathy Study letters) was worse than the mean VA of eyes without ORT (68.8 letters; P < 0.0001). At 2 years after initiation of anti-VEGF therapy for neovascular AMD, ORTs are present in a substantial proportion of eyes. We identified baseline features that independently predict ORTs. It is important to identify ORTs because eyes with ORTs have worse VA outcomes than those without this finding.

Prevalence

Prospective Studies

Humans

Male

Retinal Photoreceptor Cell Outer Segment - pathology

Vascular Endothelial Growth Factor A - antagonists & inhibitors

Retinal Diseases - epidemiology

Macular Degeneration - drug therapy

Bevacizumab

Choroidal Neovascularization - drug therapy

Choroidal Neovascularization - pathology

Retinal Diseases - etiology

Ranibizumab

Angiogenesis Inhibitors - therapeutic use

Retinal Diseases - pathology

Female

Angiogenesis Inhibitors - adverse effects

Antibodies, Monoclonal, Humanized - adverse effects

Antibodies, Monoclonal, Humanized - therapeutic use

Tomography, Optical Coherence

Risk Factors

Visual Acuity

Analysis of Variance

Aged

Macular Degeneration - pathology

Details

Title: Subtitle: Outer retinal tubulation in the comparison of age-related macular degeneration treatments trials (CATT)
Creators: Joo Yong Lee - Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina; Department of Ophthalmology, Asan Medical Center, University of Ulsan, Seoul, Korea
Francisco A Folgar - Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina
Maureen G Maguire - Department of Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania
Gui-shuang Ying - Department of Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania
Cynthia A Toth - Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina
Daniel F Martin - Department of Ophthalmology, Cleveland Clinic, Cleveland, Ohio
Glenn J Jaffe - Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina. Electronic address: glenn.jaffe@duke.edu
CATT Research Group
Contributors: James C Folk (Contributor) - University of Iowa, Ophthalmology and Visual Sciences
Douglas B Critser (Contributor) - University of Iowa, The University of Iowa Institute for Vision Research
Stephen R Russell (Contributor) - University of Iowa, Ophthalmology and Visual Sciences
Heather A Stockman (Contributor) - University of Iowa, Ophthalmology and Visual Sciences
Resource Type: Journal article
Publication Details: Ophthalmology (Rochester, Minn.), Vol.121(12), pp.2423-2431
DOI: 10.1016/j.ophtha.2014.06.013
PMID: 25064723
PMCID: PMC4254295
NLM abbreviation: Ophthalmology
ISSN: 0161-6420
eISSN: 1549-4713
Publisher: United States
Grant note: U10 EY017825 / NEI NIH HHS U10EY017826 / NEI NIH HHS
Language: English
Date published: 12/2014
Academic Unit: The University of Iowa Institute for Vision Research; Ophthalmology and Visual Sciences
Record Identifier: 9983980080102771

Metrics

28 Record Views

57 Times Cited - Web of Science