June 2021
Volume 62, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2021
Impact of Baseline Macular Atrophy on Long-Term Outcomes in Neovascular Age-Related Macular Degeneration Patients Treated with anti-VEGF Treatment
Author Affiliations & Notes
  • Mark Quoc-Tin Bui
    Case Western Reserve University School of Medicine, Cleveland, Ohio, United States
  • Grant L Hom
    Case Western Reserve University School of Medicine, Cleveland, Ohio, United States
  • Amogh Iyer
    Center for Ophthalmic Bioinformatics, Cleveland Clinic Cole Eye Institute, Cleveland, Ohio, United States
  • Aneesha Kalur
    Center for Ophthalmic Bioinformatics, Cleveland Clinic Cole Eye Institute, Cleveland, Ohio, United States
  • Justin Muste
    Center for Ophthalmic Bioinformatics, Cleveland Clinic Cole Eye Institute, Cleveland, Ohio, United States
  • Thais F. Conti
    Center for Ophthalmic Bioinformatics, Cleveland Clinic Cole Eye Institute, Cleveland, Ohio, United States
  • Rishi P Singh
    Case Western Reserve University School of Medicine, Cleveland, Ohio, United States
    Center for Ophthalmic Bioinformatics, Cleveland Clinic Cole Eye Institute, Cleveland, Ohio, United States
  • Katherine Talcott
    Center for Ophthalmic Bioinformatics, Cleveland Clinic Cole Eye Institute, Cleveland, Ohio, United States
  • Footnotes
    Commercial Relationships   Mark Bui, None; Grant Hom, None; Amogh Iyer, None; Aneesha Kalur, None; Justin Muste, None; Thais Conti, None; Rishi Singh, None; Katherine Talcott, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2021, Vol.62, 284. doi:
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    • Get Citation

      Mark Quoc-Tin Bui, Grant L Hom, Amogh Iyer, Aneesha Kalur, Justin Muste, Thais F. Conti, Rishi P Singh, Katherine Talcott; Impact of Baseline Macular Atrophy on Long-Term Outcomes in Neovascular Age-Related Macular Degeneration Patients Treated with anti-VEGF Treatment. Invest. Ophthalmol. Vis. Sci. 2021;62(8):284.

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

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Abstract

Purpose : Anti-vascular endothelial growth factor (anti-VEGF) therapy improves visual acuity (VA) in neovascular age-related macular degeneration (nAMD) patients but the impact of baseline macular atrophy (MA) on long-term visual outcomes is not well understood. This study examines how baseline MA affects long-term visual outcomes in nAMD patients treated with anti-VEGF injections.

Methods : A single eye of patients treated with anti-VEGF injections for nAMD over a 7-year time period at the Cole Eye Institute, Cleveland Clinic were included in this study. Eyes were imaged at baseline using Cirrus SD-OCT and retinal pigment epithelium (RPE) sub-illumination analysis (Cirrus High-Definition Spectral Domain-OCT Review V9.5.1; Carl Zeiss Meditec, Dublin, CA) was used to automate identification of atrophy and measure the total area of RPE sub-illumination within 5mm of the fovea. MA was determined by the presence of atrophy within 5 mm of the fovea. Segmentation errors were manually corrected. Clinical outcomes including VA, number of injections and number of appointments were collected.

Results : 68 patients (60.3% female) with mean age 81.8±9.1 years and baseline VA 68.9±13.7 ETDRS letters were included. 53 eyes (77.9%; mean age 82.1±8.6 years and baseline VA 68.7±15.0 ETDRS letters) had MA at baseline. The mean sub-RPE illumination was 2.9±2.6 mm2 in this cohort. 15 eyes did not have MA at baseline had an average age of 80.7±11.1 years and a baseline acuity of 69.7±8.4 ETDRS letters. No differences in baseline characteristics existed between the 2 cohorts (all p>0.05). At 7 years, eyes with baseline MA lost a mean 7.4 ETDRS letters (95% CI, 0.7 to 14.1) from baseline and had received a mean 38.3±16.0 injections over 52.7±16.5 appointments. At 7 years, patients (n=15) without baseline MA lost a mean 10.4 ETDRS letters (95% CI, -2.7 to 23.5) from baseline and had received a mean 40.0±14.4 injections over mean 54.3±11.3 appointments. There were no significant differences in vision loss from baseline, injections, or appointments between the 2 cohorts (all p>0.05).

Conclusions : The results of this study suggest that nAMD eyes with baseline MA treated with anti-VEGF injections were associated with progressive vision loss at 7 years. Further research is needed to examine how the progression of MA affects VA outcomes in nAMD patients treated with anti-VEGF therapy.

This is a 2021 ARVO Annual Meeting abstract.

 

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