March 2012
Volume 53, Issue 14
Free
ARVO Annual Meeting Abstract  |   March 2012
Photographic Assessment of Fundus Morphology in the Comparison of Age-related Macular Degeneration Treatments Trials (CATT)
Author Affiliations & Notes
  • Juan E. Grunwald
    Ophthal-Scheie Eye Inst, Perelman School of Medicine, Univ of Pennsylvania, Philadelphia, Pennsylvania
  • Ebenezer Daniel
    Ophthal-Scheie Eye Inst, Perelman School of Medicine, Univ of Pennsylvania, Philadelphia, Pennsylvania
  • Gui-shuang Ying
    Ophthal-Scheie Eye Inst, Perelman School of Medicine, Univ of Pennsylvania, Philadelphia, Pennsylvania
  • Maxwell Pistilli
    Ophthal-Scheie Eye Inst, Perelman School of Medicine, Univ of Pennsylvania, Philadelphia, Pennsylvania
  • Maureen Maguire
    Ophthal-Scheie Eye Inst, Perelman School of Medicine, Univ of Pennsylvania, Philadelphia, Pennsylvania
  • Judith Alexander
    Ophthal-Scheie Eye Inst, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
  • Stuart L. Fine
    University of Colorado, Denver, Colorado
  • Daniel F. Martin
    Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio
  • CATT Research Group
    Ophthal-Scheie Eye Inst, Perelman School of Medicine, Univ of Pennsylvania, Philadelphia, Pennsylvania
  • Footnotes
    Commercial Relationships  Juan E. Grunwald, None; Ebenezer Daniel, None; Gui-shuang Ying, None; Maxwell Pistilli, None; Maureen Maguire, None; Judith Alexander, None; Stuart L. Fine, None; Daniel F. Martin, None
  • Footnotes
    Support  U10 EY017823, U10 EY017825, U10 EY017826, U10 EY017828
Investigative Ophthalmology & Visual Science March 2012, Vol.53, 2896. doi:
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      Juan E. Grunwald, Ebenezer Daniel, Gui-shuang Ying, Maxwell Pistilli, Maureen Maguire, Judith Alexander, Stuart L. Fine, Daniel F. Martin, CATT Research Group; Photographic Assessment of Fundus Morphology in the Comparison of Age-related Macular Degeneration Treatments Trials (CATT). Invest. Ophthalmol. Vis. Sci. 2012;53(14):2896.

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Abstract

Purpose: : To describe the methods used for assessment of baseline fundus characteristics from color photography and fluorescein angiography (FA) in the Comparison of the Age-Related Macular Degeneration Treatments Trials (CATT), and the relationship between these characteristics and baseline visual acuity.

Methods: : Baseline stereoscopic color fundus photographs and FAs of 1185 participants in the CATT study were assessed at a central fundus photograph reading center by masked readers. Replicate assessments of random samples of photographs were performed to assess intra and inter grader agreements. The association of the characteristics with baseline visual acuity was assessed using ANOVA and correlation coefficients.

Results: : Intra and inter grader reproducibility showed agreements ranging from75% to 100% and weighted kappas ranging from 0.48 to 1.0 for qualitative determinations. The intra-class correlation coefficients were 0.96-0.97 for quantitative measurements of choroidal neovascularization (CNV) area and total area of CNV lesion. The mean visual acuity (SE) varied by the type of pathology in the foveal center: 64.5 (0.7) letters for fluid only, 59.0 (0.5) for CNV, and 58.7 (1.3) for hemorrhage (p<0.001). Fibrotic or atrophic scar present in the lesion but not under the center of the fovea was also associated with a markedly reduced visual acuity 48.4 (2.2), p<0.0001. Although total area of CNV lesion was weakly correlated with visual acuity (r=-0.16, p<0.001), the correlation was stronger within patients with predominantly classic lesions (r=-0.42, p<0.001).

Conclusions: : Our results show that the methodology used for grading CATT fundus images has good reproducibility. As expected, larger total CNV lesion area, and pathologic findings such as hemorrhage, fibrosis and atrophy are associated with decreased visual acuity.

Clinical Trial: : http://www.clinicaltrials.gov NCT00593450

Keywords: clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials • age-related macular degeneration 
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