Abstract
Purpose :
The aim of this study is to determine whether the interval at which fellow eyes are monitored impacts the severity of disease at the time of their conversion in patients with unilateral neovascular age-related macular degeneration (nAMD).
Methods :
Cross sectional study of patients with unilateral nAMD who subsequently developed nAMD in their fellow eyes between March 2015 to October 2020. Patients were divided into those who were actively receiving treatment in their first eye at the time of second eye conversion and compared with those who had stopped treatment because of reaching end-stages of the disease. Visit intervals, frequency of monitoring fellow eyes, visual acuity (VA), and central macular thickness (CMT) were abstract from the chart.
Results :
At the time of fellow eye conversion, 54 patients (71%) were receiving injections in their first eye and 22 patients (29%) had stopped treatment because of having low vision. VA in the first eyes to develop nAMD in the active treatment group was significantly better compared with the VA in eyes that had ceased treatment by the time of their conversion (logMAR 0.587±0.375 vs. logMAR 1.14±0.531, P<0.001). By contrast, VA was similar both at the time of diagnosis of the first eye (logMAR 0.384±0.436 vs. logMAR 0.367±0.328, P=0.867) and conversion of the fellow eye to nAMD (logMAR 0.492±0.412 vs. logMAR 0.465±0.400, P=0.795). The fellow eyes of patients who were actively receiving injections were monitored much more closely compared with those patients who had stopped treatment. At the visit immediately before second eye conversion, patients who were in the active treatment group had completed their last visit an average of 8.1±5.3 weeks compared with 25.5±24.8 weeks for those patients who had stopped treatment (P=0.004). Finally, the average CMT was similar for the fellow eyes that converted to nAMD in both groups (277±51 µm vs. 265±39 µm, P=0.305).
Conclusions :
Patients who stopped treatment for nAMD by the time that their fellow eye developed neovascularization were monitored less frequently compared with patients who continued on treatment for nAMD. This is surprising because a majority of these patients were functionally monocular, and therefore had more to lose from the conversion of their remaining eye. Reassuring, however, visual and structural outcomes were not tied to the interval at which the fellow eyes were being monitored.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.