Abstract
Purpose :
Intraocular erythropoietin injections have been previously demonstrated to significantly reduce the rate of expansion of AMD associated geographic atrophy lesions, but vision outcomes have not been previously reported. The Omnifield thresholds resolution throughout the central 20 degree diameter visual field under photopic and mesopic luminance conditions.
Methods :
Eyes with AMD geographic atrophy lesions adjacent to or just passing through the fovea were treated with off–label intraocular Procrit (5IU) injections at 4-6 weeks for at least one year (study IRB approved). Habitual spectacle vision measurements were obtained with the ETDRS chart, and with Omnifield measurements @99% MC of central acuity, best acuity at any intercept 6 degrees of fixation, global macular acuity, and field areas and volume measures for all intercepts thresholded at or better than 20/40 (associated with reading ability), 20/80 (facial recognition, etc), and 20/160 (extended view).
Results :
59 eyes of 54 individuals were evaluated and were compared with 28 fellow eyes (others having CNV or comorbities). ETDRS chart acuity deteriorated .17+.29 logMAR per year during treatment compared with .05+.20 per year prior, similar to the untreated group. In the Omnifields during treatment, central acuity, best acuity within 6o, and global macular acuity deteriorated similarly by .13 to .23+.50 logMAR per year while the field areas and volumes at >20/40, >20/80, and >20/160 all remained very stable throughout treatment (< 20% change per year). This compared with a .10 to .17+.47 logMAR change in acuities and 21% to 60% change per year in the field areas and volumes prior to treatment. CNV developed only in one of the 59 treated eyes but in 3 of the fellow eyes during the treatment period.
Conclusions :
The Omnifield measurements demonstrated significant stability of the field of vision during erythropoietin treatment when compared with progressive loss prior to treatment and with follow up during treatment of the fellow eyes that were evaluated (without CNV). This compares with the stabilization of the geographic atrophy lesions observed in these same eyes during treatment with erythropoietin. Central acuity measures with multiple devices demonstrated mild deterioration in both treated and untreated eyes during this limited period.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.