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Juan Pablo Real, Santiago Palma, Gladys Granero, Claudio P Juarez, Jose D Luna Pinto; Correlation between changes in visual acuity and time in age-related macular degeneration. Invest. Ophthalmol. Vis. Sci. 2014;55(13):602.
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Observe changes in visual acuity (VA) over time in patients with age related macular degeneration (AMD) from clinical diagnosis to first antiangiogenics treatment and after antiangiogenic loading doses to disease reactivation
A retrospective observational study was conducted. Patients with untreated wet ARMD, confirmed by fluorescein angiogram (FA) or optical coherence tomography (OCT) and a best corrected visual acuity (BCVA) of 20/40 to 20/320.The main outcome measures used were: the different delay times produced between indication for treatment (after initial and recurrence diagnosis) and intravitreal injection (initiation of loading dose and treatment dose for recurrence) with changes in BCVA produced along of this waiting time (WT).
Eighty-Four eyes were included. The mean duration of initial WT was 87.5 days, the mean follow-up period was 1.81 years and 35% of patient had lost of VA compatible with recurrence criteria. Both WTs were significantly correlated (rinitial=0.60,p<0.01; rrecurrence=0.85,p<0.01) with BCVA changes. Although significant by either linear or polynomial regression analysis, according index of determination, in both cases changes in BCVA during WT were best described by nonlinear polynomial regression (figure).To analysis the impact of initial WT, the cohort was divided according percentiles p33.3 and p66,6 into 3 groups for their respective comparison. During initial WT, all groups showed a statistically significant reduction in BCVA, being significantly higher in the group 3 that also showed the smallest VA improvement after loading phase (LP). An association between this improvement and WT was found (Pearson coefficient -0.26).
VA changes as a function of time show a rapid loss of VA in the early times of the disease, slowing the velocity of loss after an AV of 20/200 approx hence showing an asymptotic behavior
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