July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
The associations between the original randomized allocations and neovascular lesion morphology with low luminance acuity at the extended follow up visit in the IVAN clinical trial.
Author Affiliations & Notes
  • Alexander Foss
    Ophthalmology, Nottingham University Hospital Trust, Nottingham, United Kingdom
  • Barney Reeves
    University of Bristol, United Kingdom
  • Rebecca Nicole Evans
    University of Bristol, United Kingdom
  • Usha Chakravarthy
    Queens University of Belfast, Belfast, United Kingdom
  • Footnotes
    Commercial Relationships   Alexander Foss, None; Barney Reeves, None; Rebecca Evans, None; Usha Chakravarthy, Allergan (C), Aperlis (C), Bayer (C)
  • Footnotes
    Support  National Institute of Health Research UK
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 1177. doi:
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      Alexander Foss, Barney Reeves, Rebecca Nicole Evans, Usha Chakravarthy; The associations between the original randomized allocations and neovascular lesion morphology with low luminance acuity at the extended follow up visit in the IVAN clinical trial.. Invest. Ophthalmol. Vis. Sci. 2019;60(9):1177.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To describe associations between the original randomized allocations and neovascular lesion morphology with low luminance acuity at the extended follow up visit in the IVAN clinical trial.

Methods : Following ethics approval, 199 of 532 IVAN participants eligible for inclusion in the extended follow up attended a study visit. Best corrected visual acuity (BCVA) and low luminance acuity (LLA, 2 log neutral density filter) were measured for study and fellow eyes. Color and OCT imaging were mandatory; autofluoresence (AF) was collected for a subset of participants. Images were assessed by trained graders at netWORC UK for presence or worsening of intralesional and extra lesional macular atrophy (ILMA and ELMA respectively). Linear regression was used to analyse the effects of randomized allocations and development or worsening of ILMA and ELMA in study eyes on BCVA and LLA at follow up. Both regression models were adjusted for BCVA at IVAN exit; LLA was not measured during the IVAN trial and BCVA at IVAN exit was the best covariate available for adjustment.

Results : The median duration of follow up (FU) was 5.3 years (interquartile range, 4.8 to 5.8). At follow-up, BCVA was available for 199 attenders and LLA for 191. Randomized allocations to drug and treatment regimen were not significantly associated with either BCVA or LLA. BCVA was 5.3 letters (95% CI -11.8 to 1.3) lower in study eyes in which ILMA had developed or worsened after IVAN exit compared to eyes without ILMA or in which ILMA did not worsen. LLA was 12.7 letters (-19.0 to -6.4) lower in study eyes in which ILMA developed new or worsened after IVAN exit. Similarly, greater reductions in LLA compared to BCVA were seen in study eyes with ELMA than without.

Conclusions : Low luminance acuity was worse in study eyes with ILMA and ELMA lesions compared to eyes without ILMA or ELMA. BCVA did not distinguish between these groups of study eyes. These findings imply that LLA is more sensitive test of the vision impairment due to atrophy.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

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