Purchase this article with an account.
Chandruganesh Rasendran, Alexander Haueisen, Andrew Xie Chen, Grant L Hom, Thais Conti, Tyler Greenlee, Isaac Briskin, Rishi P Singh, Katherine Talcott; Visual outcomes following cataract surgery in geographic atrophy patients in routine clinical practice. Invest. Ophthalmol. Vis. Sci. 2020;61(7):3386.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Few studies have assessed visual outcomes, including prognostic variables, of cataract surgery in patients with geographic atrophy (GA) in the setting of age-related macular degeneration. This study aims to determine visual acuity (VA) outcomes of cataract surgery in patients with fovea-involving GA and to assess the prognostic value of baseline ocular and systemic characteristics.
This retrospective cohort study compared patients with fovea-involving GA to age- and baseline VA-matched control patients undergoing cataract surgery from 2015-2017 at the Cleveland Clinic. VA and optical coherence tomography (OCT) data including central subfield thickness (CST) and retinal pigment epithelium (RPE) sub-illumination area within 5 mm of foveal center were collected at pre-operative, post-operative month 1 (POM1), and post-operative month 12 (POM12) visits. POM12 VA was the primary outcome measure.
Thirty-five eyes with fovea-involving GA and 31 controls were included. GA and control groups were similar in terms of baseline VA (37.3±19.5 and 45.1±12.6 ETDRS letters, respectively, p=0.06), age (79.3±6.8 and 77.6±4.1 years, respectively, p=0.11), and proportion of smokers or former smokers (77.1% and 58.1%, respectively, p=0.10). At POM12, the GA cohort had no significant change in VA from baseline (+2.1 ± 17.3 letters, p=0.68), while the control cohort experienced a significant gain in VA (+30.0±12.9 letters, p<0.01). GA area, as represented by RPE sub-illumination area based upon SDOCT, did not change between baseline and 12 months when adjusting for baseline size (5.7 vs. 6.1 mm2, p=0.78). Baseline VA (p=0.007) and CST (p=0.015) were significant predictors of change in VA at POM12, and were negatively and positively associated, respectively. Age at surgery and GA area at baseline were not significant predictors.
Cataract surgery may provide marginal benefit to VA in fovea-involving GA, but may still offer visual benefits not measured by VA and should be considered on a case-by-case basis.
This is a 2020 ARVO Annual Meeting abstract.
This PDF is available to Subscribers Only