Abstract
Purpose :
To estimate rates of progression to geographic atrophy (GA) or choroidal neovascularization (CNV) among eyes diagnosed with early/intermediate age-related macular degeneration (AMD).
Methods :
We extracted electronic care records from 10 UK eye clinics, identified patients with early/intermediate AMD in at least one eye, and classified them as follows: early/intermediate AMD in both eyes (E:E), early/intermediate AMD in one eye and CNV, GA, or both GA and CNV (Mixed) in the contralateral eye (E:CNV, E:GA or E:Mixed, respectively). The primary outcome was progression to GA or CNV in the at-risk eye. Cox-Proportional Hazards model was used to estimate rates of progression to advanced AMD phenotypes.
Results :
Of the 83,425 persons in the dataset, 40,543 (48.6%) were eligible for inclusion, of which 32,655 (80.5%), 7,069 (17.4%), 656 (1.6%), and 163 (0.4%) were categorized as E:E, E:CNV, E:GA, and E:Mixed, respectively. In eyes with early/intermediate AMD, the rate of progression to GA was 2%, 4%, 11% and 8% per year for the E:E, E:CNV, E:GA and E:Mixed groups, respectively, while the rate of progression to CNV was 3%, 15%, 9% and 12% per year among the 4 cohorts, respectively. The adjusted rate of progression to GA was highest in the E:GA group, and the adjusted rate of progression to CNV was highest in the E:CNV group (Table 1).
Conclusions :
Progression to GA or CNV was frequently observed in eyes with early/intermediate AMD, more commonly so in patients with advanced disease in the contralateral eye. Rate of progression to GA was more rapid in patients with GA in the contralateral eye just as the rate of progression to CNV was more rapid in patients with CNV in the contralateral eye. This large analysis of electronic care records contributes to our understanding of the natural history of eyes with early/intermediate AMD.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.