Abstract
Purpose :
To compare the outcomes at one year between the first and second eyes in patients who develop sequential age-related neovascular macular degeneration (nAMD).
Methods :
Treatment-naive patients who sequentially developed nAMD between March 2015 and March 2020 were identified. Outcomes at one-year were compared between the first and second eyes to develop nAMD. All patients were treated with an initial series of 3 monthly loading doses of anti-VEGF agents, followed by further intravitreal injections (IVI) as required. Outcomes included visual acuity (VA), central macular thickness (CMT), as well as evidence for geographic atrophy (GA) and/or pigment epithelial detachment (PED) on optical coherence tomography (OCT) imaging.
Results :
Fifty-six patients who sequentially developed nAMD were identified. The mean age was 81.5 ± 7.9 (range 60-94) and 66% were female. The average time to diagnosis of nAMD in the second eye was 474 ± 369 days. The mean number of IVI for the first eye before second eye conversion was 7.8 ± 6.2 (range 1-33). There was no difference in the number of IVI in the first compared with the second eye at one year (8.4 ± 2.6 injections versus 9.0 ± 2.0, P=0.269). VA at diagnosis and after 12 months were better for the second eye compared with the first eye to develop nAMD (0.72 ± 0.53 logMAR vs. 0.41 ± 033 logMAR, P<0.001, and 0.67 ± 0.63 logMAR vs. 0.42 ± 0.36 logMAR, P=0.008). CMT at diagnosis was thicker for the first eye compared with the second eye to develop nAMD (381 ± 120 µm vs. 335 ± 94 µm, P=0.017), but was similar at one year (296 ± 100 µm vs. 278 ± 82 µm P=0.193). At diagnosis, PED height was thicker for the first eye compared with the second eye to develop nAMD (236±208 µm vs. 154±155 µm, P=0.009), but was similar at one year (195±170 µm vs. 141±139 µm, P=0.053). Finally, 3 eyes (5.4%) had GA at the time of nAMD diagnosis in the first eye, whereas 8 eyes (14%) had GA at the time that the second eye developed nAMD (χ2=2.520, P=0.112). There was a correlation between presence of GA in the first eye and the development of GA in the second eye by the time of its diagnosis (r=0.356, P=0.007).
Conclusions :
At diagnosis the second eye to develop nAMD tends to have better vision and thinner CMT. Although these eyes had better anatomical outcomes at one year, this did not translate into better vision nor a lower disease burden requiring less treatment
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.