June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Baseline Predictors of Five-Year Visual Acuity in the Comparison of AMD Treatment Trials (CATT)
Author Affiliations & Notes
  • Gui-Shuang Ying
    Ophthalmology, Scheie Eye Institute, University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • Maureen G Maguire
    Ophthalmology, Scheie Eye Institute, University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • Wei Pan
    Ophthalmology, Scheie Eye Institute, University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • Juan E Grunwald
    Ophthalmology, Scheie Eye Institute, University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • Ebenezer Daniel
    Ophthalmology, Scheie Eye Institute, University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • Glenn J Jaffe
    Ophthalmology, Duke University, Durham, North Carolina, United States
  • Cynthia A Toth
    Ophthalmology, Duke University, Durham, North Carolina, United States
  • Daniel F Martin
    Ophthalmology, Cleveland Clinic , Cleveland, Ohio, United States
  • Footnotes
    Commercial Relationships   Gui-Shuang Ying, Chengdu Kanghong Biotech Co (C), Janssen Research & Development (C); Maureen Maguire, Genentech (C); Wei Pan, None; Juan Grunwald, None; Ebenezer Daniel, None; Glenn Jaffe, Heidelberg Engineering (C); Cynthia Toth, Alcon Laboratories  (P), Genentech   (F); Daniel Martin, None
  • Footnotes
    Support  Cooperative agreements U10 EY023530, U10 EY017823, U10 EY017825, U10 EY017826, and U10 EY017828 from the National Eye Institute, National Institutes of Health, Department of Health and Human Services
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 886. doi:
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    • Get Citation

      Gui-Shuang Ying, Maureen G Maguire, Wei Pan, Juan E Grunwald, Ebenezer Daniel, Glenn J Jaffe, Cynthia A Toth, Daniel F Martin; Baseline Predictors of Five-Year Visual Acuity in the Comparison of AMD Treatment Trials (CATT). Invest. Ophthalmol. Vis. Sci. 2017;58(8):886.

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

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Abstract

Purpose : To determine baseline predictors of visual acuity (VA) outcomes at 5 years after initiating treatment with ranibizumab or bevacizumab for neovascular age-related macular degeneration.

Methods : Participants were randomly assigned to receive ranibizumab or bevacizumab and to 1 of 3 dosing regimens. After two years, patients were released from the clinical trial protocol, and were recalled for examination at 5 years. Masked trained readers evaluated baseline fundus morphology on color photographs and fluorescein angiography, fluid within and thickness of the retina on time-domain optical coherence tomography (TD-OCT). Outcomes for the study eye at 5 years included VA score, VA score change from baseline, ≥3-line gain, ≥3-line loss, and VA 20/200 or worse. Predictors (demographics, ocular characteristics, and OCT measures) were screened using univariate analysis. Independent predictors were identified with multiple regression analysis using a backward selection method.

Results : Among 647 patients with VA outcomes at 5 years, the mean VA score at 5 years was 59 letters, with a mean decrease of 3.3 letters from baseline, 17.6% with ≥3-line gain, 23.6% with ≥3-line loss, and 20% with 20/200 or worse. In multivariate analysis (Tables 1&2), worse baseline VA was associated with worse VA, more VA gain, higher percentage of ≥3-lines gain, and higher percentage of 20/200 or worse at 5 years (all p<0.001); larger baseline CNV lesion area was associated with worse VA, larger VA loss, higher percentage of ≥3-lines loss, and higher percentage of 20/200 or worse at 5 years (all p<0.05); absence of subretinal fluid was associated with worse VA (p=0.03) and larger VA loss (p=0.03); female gender, bevacizumab treatment in the first 2 years, and absence of RPE elevation were associated with a higher percentage of ≥3-line gain; cigarette smoking was associated with a higher percentage with 20/200 or worse.

Conclusions : At 5 years after initiating treatment with ranibizumab or bevacizumab in CATT participants, male gender, cigarette smoking, treatment with ranibizumab in the first 2 years, larger area of CNV lesion, absence of sub-retinal fluid and presence of RPE elevation at baseline are independently associated with worse vision outcomes at 5 years; while worse baseline VA in study eye was independently associated with worse 5-year VA and more VA gain from baseline.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

 

 

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