Purchase this article with an account.
A. Dugar, J. Bakal, S. Sharma; Progression of Visual Loss is Associated with Duration of Wet Age–Related Macular Degeneration . Invest. Ophthalmol. Vis. Sci. 2004;45(13):3065.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Purpose: To determine if the duration of the presence of wet AMD is associated with visual deterioration. Methods: A prospective study of consecutive AMD patients (n=38) who presented with newly diagnosed CNV was conducted in a tertiary care retinal practice to evaluate if the duration of the presence of wet AMD, as defined as the time elapsed between initial diagnosis and referral assessment/treatment, was associated with any visual deterioration that may have occurred in the intervening period. All eligible subjects underwent clinical examination and digital fluorescein angiography. Subjects with angiographic diabetic macular edema or ischemia, or IOP greater than 21 mmHg were excluded from the study, as were those with significant lenticular opacification. Data regarding our dependent variable were recorded by a researcher masked to all clinical data, as was angiographic assessment. Pearson correlations were performed to assess the correlation between continuous independent variables and any visual deterioration that may have occurred in the intervening period. Multivariate linear regression models using stepwise techniques were used to evaluate associations between the dependent variables and visual progression, while controlling for potential clinical co–variates. Results: Thirty–two patients (84%) met our various inclusion and exclusion criteria; no differences in important variables were noted between those included and excluded from our study. Our sample had a mean age of 77 years (sd = 8.7), and 75% (n= 24) were females. Six percent of patients (n = 2) had exclusively classic membranes, 44% (n =14) had predominantly classic lesions, 19% (n = 6) had minimally classic lesions, and 31% (n = 10) had occult CNV. The median time elapsed between initial diagnosis and referral assessment/treatment was 28 days (IQR = 36.5), and 44% (n= 14) of subjects developed some degree of visual loss. The time elapsed between initial diagnosis and treatment was correlated with progression of visual loss (r =0.50, p = 0.003). Multivariate linear regression using stepwise variable selection demonstrated that only the time elapsed and lesion type based on fluorescein angiography were associated with progression of visual loss, (R2 = 0.49, F(4,28) = 6.744, p=0.01). Lesion size, age and gender were not significantly associated with progression of visual loss (p>0.05). Conclusions:Delay in treatment of new–onset wet AMD is associated with a higher risk of visual loss.
This PDF is available to Subscribers Only