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JS Sunness, NM Bressler, CA Applegate, U Chukwueke; Long-term Progression of Visual Acuity in Age-related Geographic Atrophy From AMD . Invest. Ophthalmol. Vis. Sci. 2002;43(13):2905.
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Purpose: To describe the long-term rate of visual acuity loss in geographic atrophy (GA) from AMD. Methods: A prospective natural history study enrolled 157 subjects with GA in one or both eyes. Ninety five subjects had bilateral GA and no CNV, 45 had GA without CNV in the study eye and CNV in the fellow eye, 15 had GA in the study eye and drusen in the fellow eye, and 2 patients had fellow eyes that could not be evaluated. Annual follow-up data is available for 112 at one year, 100 at two, 87 at three, 76 at four, and at 63 subjects at five years. At each visit, best-corrected ETDRS visual acuity was measured after a protocol refraction. Kaplan-Meier survival analysis was performed to determine the rate of visual loss. Results: For all subjects, rates for 3 line visual loss were 10% by one year, 26% by two, 36% by three, 54% by four, and 74% by five years. A six line visual acuity loss was seen in 5% by one year, 10% by two, 18% by three, 26% by four, and 40% by five years. For eyes with visual acuity better than 20/50, the rates of loss were more rapid. For these good acuity eyes (n=77 at baseline), the rates of three line visual acuity loss were 13% by one year, 34% by two, 46% by three, 66% by four, and 90% by five years. The six line VA loss rate in these eyes was 5% by one year, 15% by two, 21% by three, 39% by four, and 60% by five years. For these eyes with good VA initially, the rates of developing VA of 20/200 or worse were 3% by one year, 6% by two, 12% by three, 20% by four, and 33% by five years. There was no difference between the bilateral GA group and the fellow eye CNV group in terms of the rates of acuity loss. Conclusion: Geographic atrophy is associated with a significant loss of visual acuity over time. These data can be used in the design of future treatment trials.
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