June 2015
Volume 56, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2015
Visual outcomes and macular atrophy in non-study eyes in ANCHOR/MARINA subjects (SEVEN-UP Study)
Author Affiliations & Notes
  • Shilpa Desai
    Ophthalmology, UCSF, San Francisco, CA
  • Robert B Bhisitkul
    Ophthalmology, UCSF, San Francisco, CA
  • Wayne Enoria
    Ophthalmology, UCSF, San Francisco, CA
  • Soraya Rofagha
    Ophthalmology, UCSF, San Francisco, CA
  • David S Boyer
    Retina Vitreous Associates Medical Group, Los Angeles, CA
  • Srinivas R Sadda
    University of California, Southern California, Los Angeles, CA
  • Kang Zhang
    University of California San Diego, San Diego, CA
  • Footnotes
    Commercial Relationships Shilpa Desai, None; Robert Bhisitkul, None; Wayne Enoria, None; Soraya Rofagha, None; David Boyer, None; Srinivas Sadda, None; Kang Zhang, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2015, Vol.56, 2836. doi:
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    • Get Citation

      Shilpa Desai, Robert B Bhisitkul, Wayne Enoria, Soraya Rofagha, David S Boyer, Srinivas R Sadda, Kang Zhang; Visual outcomes and macular atrophy in non-study eyes in ANCHOR/MARINA subjects (SEVEN-UP Study). Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):2836.

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

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Abstract

Purpose: To compare long-term visual outcomes and macular atrophy in fellow eyes from a cohort of AMD patients who participated in the ANCHOR, MARINA, and HORIZON trials.

Methods: Sixty-five patients with exudative AMD were evaluated in a prospective, uncontrolled, non-interventional study to measure the efficacy of ranibizumab. In ANCHOR/MARINA, “study eyes” underwent a protocol of monthly ranibizumab injections for 2 years. “Fellow eyes” received no treatment. At a mean of 7 years after study entry, patients were recruited for a single update visit to evaluate vision and collect fluorescein angiography (FA) and fundus autofluorescence (FAF). Macular atrophy area was measured in a masked, independent fashion from analysis of FA and FAF. Fellow eyes were divided into three sub-groups based on exudative status. Statistical analyses were performed using Spearman Rank Correlation.

Results: In fifty subjects for whom fellow eye data was available, at year 7, study eyes had an average ETDRS vision score of 45.1±25.6 letters, and mean macular atrophy of 2.8±2.20 mm2. Fellow eyes overall had a mean ETDRS score of 50.5±27.8 letters, a decline from 60.1±12.4 letters at Day 0. For Year 7 outcomes in the fellow eye subgroups, eyes with exudative AMD from day 0 (N = 17) had mean vision of 27.3±19.0 letters, and macular atrophy area of 5.75±2.52 mm2, having received only 3.33±7.06 anti-VEGF injections since HORIZON Study exit. Fellow eyes that converted to exudative AMD during the 7-year period (N = 15) had mean vision of 65.1±15.6 letters, macular atrophy area of 2.67±2.78 mm2, and received 11.3±8.08 anti-VEGF injections. Finally, fellow eyes that remained dry throughout the 7-year period (N = 16) had mean vision of 68.6±24.3 letters and macular atrophy area of 1.07±1.67 mm2. A statistically significant relationship between the mean macular atrophy area and the EDTRS letters was found; P < 0.001, slope = -6.96.

Conclusions: Over a 7-year interval since entry into the ANCHOR/MARINA trials, fellow eyes, which could be treated with anti-VEGF after Year 2, showed an overall 10-letter visual decline. Compared to study eyes receiving monthly ranibizumab for 2 years, the subgroup of fellow eyes with exudative AMD duration of 7 years or more had worse vision outcomes and macular atrophy severity. In fellow eyes overall, a greater area of macular atrophy was a significant determinant of decreased long-term vision outcomes.

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