June 2020
Volume 61, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2020
Characteristics of fellow eye conversion to neovascular age-related macular degeneration in patients with unilateral neovascular disease
Author Affiliations & Notes
  • David Xu
    Wills Eye Hospital/Mid Atlantic Retina, Philadelphia, Pennsylvania, United States
  • Matthew R Starr
    Wills Eye Hospital/Mid Atlantic Retina, Philadelphia, Pennsylvania, United States
  • Luv Patel
    Wills Eye Hospital/Mid Atlantic Retina, Philadelphia, Pennsylvania, United States
  • Michael J Ammar
    Wills Eye Hospital/Mid Atlantic Retina, Philadelphia, Pennsylvania, United States
  • Nick Boucher
    Vestrum Health, Ottawa, Ontario, Canada
  • Namrata Saroj
    All Eyes Consulting LLC, New York, New York, United States
  • Allen C. Ho
    Wills Eye Hospital/Mid Atlantic Retina, Philadelphia, Pennsylvania, United States
  • Footnotes
    Commercial Relationships   David Xu, None; Matthew Starr, None; Luv Patel, None; Michael Ammar, None; Nick Boucher, Vestrum Health (E); Namrata Saroj, Regeneron Pharmaceuticals (E); Allen Ho, Alcon (C), Alcon (F), Allergan (C), Allergan (F), Genentech (C), Genentech (F), Iconic (F)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 2637. doi:
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      David Xu, Matthew R Starr, Luv Patel, Michael J Ammar, Nick Boucher, Namrata Saroj, Allen C. Ho; Characteristics of fellow eye conversion to neovascular age-related macular degeneration in patients with unilateral neovascular disease. Invest. Ophthalmol. Vis. Sci. 2020;61(7):2637.

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

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Abstract

Purpose : The fellow eye of patients with unilateral neovascular age-related macular degeneration (nAMD) treated with intravitreal anti-vascular endothelial growth factor (VEGF) injections may undergo conversion to nAMD. Assessing the incidence of conversion in a real-world setting can yield clinically relevant insights.

Methods : We retrospectively analyzed longitudinal, aggregated electronic health records from multiple retinal centers across the United States (Vestrum Health Retina Database). Patients were included with unilateral nAMD treated with anti-VEGF therapy between January 1, 2013 and August 31, 2019. All patients had at least 3 years of follow up after initiating treatment in the first eye. The frequency of fellow eye conversion within a 3-year window after onset of nAMD in the first eye was calculated. Visual acuity (VA) and central retinal thickness (CRT) at time of development of nAMD was recorded for both eyes when data was available.

Results : A total of 42,674 patients with unilateral nAMD who had received their first anti-VEGF treatment between January 1, 2013 and August 31, 2016 were included. Fellow eyes of 18,899 (44%) patients converted to nAMD during the study period. Among these, 6,098 (14%), 4,378 (10%) and 3,572 (8%) patients converted in years 1, 2 and 3 respectively after diagnosis in the first eye. The median time to conversion in the second eye was 655 days. Mean VA at time of diagnosis of nAMD in the first eye (n=10,491) was 51.8 ETDRS letters (~ 20/100) and 57.2 ETDRS letters (~20/80) in the fellow eye (p<0.0001). At 12 months, mean VA was 52.6 ETDRS letters (~20/100) in the first eye and 57.5 ETDRS letters (~20/80) in the second eye (p<0.0001). The breakdown of VA is provided in Table 1. CRT at time of diagnosis (n=2,806) in the first eye was 326 microns versus 312 microns in the fellow eye (p <0.0001).

Conclusions : Patients with unilateral nAMD have significant rates of conversion of the fellow eye. The fellow eye should be monitored at regular intervals to detect signs of neovascularization. Fellow eyes presented with significantly better vision at diagnosis than the initial eye and maintained better VA at 12 months.

This is a 2020 ARVO Annual Meeting abstract.

 

Table 1. Visual acuity at the time of diagnosis of neovascular age-related macular degeneration in the first eye compared to the corresponding fellow eye.

Table 1. Visual acuity at the time of diagnosis of neovascular age-related macular degeneration in the first eye compared to the corresponding fellow eye.

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