June 2015
Volume 56, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2015
Retinal Angiomatous Proliferation and Treatment Outcomes in the Comparison of Age-Related Macular Degeneration Treatments Trials (CATT)
Author Affiliations & Notes
  • Ebenezer Daniel
    Ophthalmology, University of Pennsylvania, Philadelphia, PA
  • Maureen G Maguire
    Ophthalmology, University of Pennsylvania, Philadelphia, PA
  • James Shaffer
    Ophthalmology, University of Pennsylvania, Philadelphia, PA
  • Gui-Shuang Ying
    Ophthalmology, University of Pennsylvania, Philadelphia, PA
  • Juan E Grunwald
    Ophthalmology, University of Pennsylvania, Philadelphia, PA
  • Glenn J Jaffe
    Ophthalmology, Duke University, Durham, NC
  • Daniel F Martin
    Ophthalmology, Cleveland Clinic, Cleveland, OH
  • Footnotes
    Commercial Relationships Ebenezer Daniel, None; Maureen Maguire, Genentec (C), IDx (F); James Shaffer, None; Gui-Shuang Ying, None; Juan Grunwald, None; Glenn Jaffe, Alcon (C), Heidelberg Engineering (C), Neurotec (C); Daniel Martin, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2015, Vol.56, 2833. doi:
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    • Get Citation

      Ebenezer Daniel, Maureen G Maguire, James Shaffer, Gui-Shuang Ying, Juan E Grunwald, Glenn J Jaffe, Daniel F Martin, Comparison of Age-related Macular Degeneration Treatments Trials (CATT) Research Group; Retinal Angiomatous Proliferation and Treatment Outcomes in the Comparison of Age-Related Macular Degeneration Treatments Trials (CATT). Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):2833.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose
 

To compare baseline characteristics, visual acuity (VA), treatment characteristics and morphological outcomes between eyes with Retinal Angiomatous Proliferation (RAP) and all other eyes among patients with neovascular age-related macular degeneration (nAMD) treated with anti-vascular endothelial growth factors (anti-VEGF)

 
Methods
 

Certified graders evaluated baseline and follow-up morphology in digital color fundus photographs, fluorescein angiography (FA), and optical coherence tomography (OCT) of eyes having nAMD receiving randomly assigned treatment with either ranibizumab or bevacizumab and 3 different dosing regimens over a 2-year period in a prospective cohort study

 
Results
 

RAP was present in 126 of 1183 (10.6%) study eyes at baseline. RAP patients were older (82 vs 79 years; p<0.001) and smoked less (45 vs 59%; p=0.004). At baseline, RAP eyes compared with other eyes had smaller choroidal neovascularization (CNV) (1.2 vs 1.9 disc areas [DA]; p<0.001), smaller total lesion size (1.6 vs 2.6 DA; p <0.001), more intraretinal fluid (93 vs 73%; p<0.001) and less subretinal fluid (67 vs 84%; p<0.001). A lower proportion had CNV at the foveal center (39.7 vs 60.3%; p<0.001) and a higher proportion had fluid on FA (48 vs 24%; p<0.001). At 1 year, RAP eyes had less fluid (54 vs 73%; p<0.001), less leakage on FA (34 vs 44%; p=0.03), more reduction in foveal thickness (-240 vs -161u, p<0.001), more GA (24 vs 15%; p=0.01), less scar (17 vs 36%; p<0.001), and less subretinal hyper reflective material (SHRM) (36 vs 48%; p=0.01) with similar results at 2 years. The mean VA improvement from baseline was greater (10.6 vs 6.9 letters; p=0.01) at one year but similar at 2 years (7.8 vs 6.2; p=0.34) (Figure). The mean change in lesion size at 1 year differed (-0.27 vs 0.27 DA; p=0.02) but was similar at 2 years (0.49 vs 0.79; p=0.26). Among eyes treated PRN, RAP eyes received a lower mean number of injections through both 1 year (6.07 vs 7.42; p=0.003) and 2 years (11.1 vs 13.6; p=0.01)

 
Conclusions
 

RAP eyes treated with anti-VEGF drugs in CATT were less likely to have FA leakage, scar, and SHRM and more likely to have GA at 1 or 2 years. Although VA gain was greater and lesion growth was less in RAP eyes at 1 year; by 2 years they were similar to other eyes  

 
Mean visual acuity over time by presence of RAP lesion at baseline
 
Mean visual acuity over time by presence of RAP lesion at baseline

 
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