Abstract
Purpose :
A recent report revealed that cilio-retinal arteries (CRA) may confer a protective effect against developing advanced age-related macular degeneration (AMD). We sought to further characterize the relationship between the presence of CRA and incidence of advanced AMD, including geographic atrophy (GA) and choroidal neovascularization (CNV).
Methods :
CATT participants with CNV in the study eye and without advanced AMD in the fellow eye at baseline and who were followed-up for 5 years were eligible for this analysis. Presence of CRA in both eyes was determined by 2 graders, masked to all clinical data, using color and red-free fundus photographs and fluorescein angiography. Presence of advanced AMD through 5 years of follow-up had previously been determined in the CATT study. Among fellow eyes, we assessed the association of CRA with incidence of a CNV and GA at 5 years. Similar analysis was performed among study eyes for association between CRA and incidence of GA. In addition, we compared the proportion with CRA between the study eye with CNV and fellow eye without CNV at baseline.
Results :
700 eyes from 350 subjects were included. The mean age was 77 years and 34% were men. CRA was present in 19.4% of fellow eyes and 20.9% of study eyes (p=0.60). CRA in fellow eyes was not associated with incidence of CNV at 5 years (45.0% in eyes without CRA, and in 44.8% of eyes with CRA, p=0.99), nor with incidence of GA at 5 years (40.0% of eyes without CRA, and 37.9% of eyes with CRA, p=0.89, Table 1). CRA in study eyes treated with anti-VEGF agents was not associated with incidence of GA at 5 years (39.0% in study eyes without CRA and 36.6% in eyes with CRA, p=0.72). In addition, there was no association between presence of CRA and AREDS severity score at baseline (p=0.82).
Conclusions :
Contrary to previous publications, our analysis did not found any association between CRA and incidence of CNV and GA. The reason for the conflicting results is unclear but may be partly explained by the difference in study populations; the study eyes in CATT had CNV at baseline, whereas previous publications used data from cohorts with less advanced AMD.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.