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Nadezhda Cvetkova, David Maerker, Horst Helbig, University of Regensburg; Progression of geographic atrophy in patients receiving anti-vascular endothelial growth factor for neovascular age-related macular degeneration (AMD): five year follow up. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1515.
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© ARVO (1962-2015); The Authors (2016-present)
To determine the area and progression of geographic atrophy in patients with neovascular AMD from 2007 till 2012 using fundus autofluorescence region finder software for OCT Spectralis (Heidelberg Engineering).<br />
In this study 73 eyes of 69 patients with neovascular AMD (mean 74 years) were included. We measured the area and progression of geographic atrophy using fundus autofluorescence region finder software for a period of five years. Additionally we investigated the best-corrected visual acuity (BCVA), the number of intavitreal injections and the central retinal thickness measured by optical coherence tomography (OCT Spectralis, Heidelberg Engineering).<br />
At baseline 52% of study eyes had a single area of geographic atrophy. After five years 71% of study eyes showed geographic atrophy. Mean geographic atrophy size increased from 1.233mm² (SD 1.797) at baseline to 5.094mm² (SD 3.486) after five years of follow up based on quantitative fundus autoflourescence evaluation. On average, the enlargement rate of geographic atrophy per year was 1,170 mm² (range 0,516mm²- 1,994mm²/year). The enlargement rate correlated with the initial area of geographic atrophy (P<0.001). There was a significant correlation between the progression of geographic atrophy and the number of intravitreal injections over five years (P<0.001). In 66 % of study eyes we detected loss of visual acuity, which was associated with a progression of geographic atrophy. There was no statistical significant difference between central retinal thickness measured by OCT at the beginning and after five years of therapy.<br />
Fundus autoflourescence region finder can be used to visualize and quantify the size and progression of geographic atrophy in patients with neovascular AMD in the daily routine. This study showed a correlation between the initial area of geographic atrophy and the enlargement rate in patients with neovascular AMD. There was a significant correlation between the number of intravitreal injections and the progression of geographic atrophy.<br />
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