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Felipe Conti, Michael Han, Karen Wai, Weilin Song, Rishi P Singh; Characterization of Geographic Atrophy Patients in a Large Cohort from The United States Medical Records. Invest. Ophthalmol. Vis. Sci. 2018;59(9):5538. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
Geographic atrophy (GA) represents an important concern as it leads to visual impairment and affects more than 5 million age-related macular degeneration (AMD) patients worldwide. The purpose of this study was to characterize the incidence of GA, the interrelationship between GA and choroidal neovascularization (CNV), the mean best-corrected visual acuity (BCVA), the incidence of visual impairment, and the incidence of blindness.
A retrospective chart review was performed from May 2012 to January 2016 at Cole Eye Institute, Cleveland Clinic, in a highly-structured clinical dataset. Patients were included if any AMD code (ICD-9 and ICD-10) was recorded. They were excluded if any of the following criteria were met: (a) age ≤50 years; (b) presence of GA was not documented in at least one eye; (c) presence of CNV in both eyes; (d) no information was found for the fellow eye in the EMR system. Patients were distributed into 3 cohorts according to the diagnosis of the fellow-eye: (1) GA:GA; (2) GA:CNV; (3) GA:early/intermediate AMD. Demographic variables and ocular findings were evaluated.
Data from 19,359 AMD patients were retrieved. After exclusion criteria were applied, 1,139 charts were selected (502 in GA:GA group; 403 in GA:CNV group; and 234 in GA:AMD group). Mean BCVA in affected eye was 50.3(±22.1) letters in the GA:GA group, 52.5(±21.3) letters in the GA:CNV group, and 48.5(±23.6) letters in the GA:AMD group. Visual impairment was determined by ineligibility for an unrestricted driver license (BCVA ≥ 70 letters in the best-seeing eye), which was present in 70.5% of GA:GA, 59.7% of GA:CNV, and 60.4% of GA:AMD patients. Criteria for blindness (BCVA < 20 letters in the best-seeing eye) was seen in 2.2% of the GA:GA, 3% in the GA:CNV, and 0.8% in the GA:AMD patients. Table 1 displays other variables assessed within groups.
This study reports the baseline characteristics and dissimilarities between subgroups of GA patients within clinical practice. Key differences that exist between the cohorts impact both social and health care costs.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
Demographics and medical characteristics of patients diagnosed with GA. SD- Standard deviation. BMI- body mass index. VA – Visual Acuity. ETDRS – Early treatment diabetic retinopathy study. OCT – ocular coherence tomography. AREDS - Age-Related Eye Disease Study.
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