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aseel hamoud bedan, Saad Younis, Mathew Kurumthottical, Abi Goodluck, Elizabeth Yang, Claudia Quijano; Progression of Geographic Atrophy in Patients with Wet Age-Related Macular Degeneration Undergoing Anti-VEGF Therapy. Invest. Ophthalmol. Vis. Sci. 2017;58(8):1945.
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© ARVO (1962-2015); The Authors (2016-present)
This study will assess the development of Geographic Atrophy with anti-VEGF injections in patients with wet AMDPrimary Outcome Measures:Development of New GA in Patients with wet AMDThe mean change in area of GA in the study eye from baseline to month 60Secondary Outcome MeasuresNumber of injections Time Frame: 1-60 monthsMean change in Visual AcuityMean change in area of existing and newly developed GA Time Frame: Month 1-60Measured by multimodal imaging assessed by Western Eye Hospital reading centerProportion of patients showing GA Time Frame: Month1-60Mean change in central macular thickness Time Frame: Months 1-60Proportion of patients showing intraretinal fluid ,subretinal fluid,pegment epithelial detachment Time Frame: Months1, 12, 24,36,28,60
Out of 1700 patients received anti VEGF injections for wet AMD, 235 eyes (86.7 +/- 6.8 years, 64% women) developed GA. All eyes were imaged at baseline and at each visit with the Cirrus spectral domain OCT.We recorded the presence of pigment epithelial detachment , sub-retinal fluid and intra-retinal fluid at baseline and after the progression of GA. Fundal photos with autoflouresceine images were taken at baseline and after the progression of GA. The area of the atrophy was measured and we measured its distance from the fovea. Baseline factors, types and numbers of antivascular endothelial growth factor injections received over time were correlated with the development and enlargement of atrophy.
Among the 1700 eyes GA developed by 5 years in 230 eyes 13.8% of eyes without GA at baseline. A multiple regression analysis was performed to evaluate the influence of gender, age, medication injected, and number of injections on GA. Except for the number of total injections R2 = 0.2, P < 0.01, the studied variables could not significantly predict development or progression of GA P = 0.43, R2 = 0.04.
Geographic atrophy is a frequent finding in eyes with wet age-related macular degeneration both before and after antivascular endothelial growth factor therapy. The frequency of new optical coherence tomography-defined atrophy 10.7% at 2 years after starting therapy. The rate of GA enlargement was positively correlated with the number of injections but did not appear to be greater than that reported for atrophy in the absence of choroidal neovascularization.
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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