June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Conversion Rates from Non-exudative to Exudative Age-Related Macular Degeneration: An AAO IRIS Registry Analysis
Author Affiliations & Notes
  • Connor Ross
    Massachusetts Eye and Ear, Boston, Massachusetts, United States
    Harvard Medical School, Boston, Massachusetts, United States
  • Dan Gong
    Massachusetts Eye and Ear, Boston, Massachusetts, United States
    Harvard Medical School, Boston, Massachusetts, United States
  • Nathan Hall
    Massachusetts Eye and Ear, Boston, Massachusetts, United States
    Harvard Medical School, Boston, Massachusetts, United States
  • Tobias Elze
    Massachusetts Eye and Ear, Boston, Massachusetts, United States
    Harvard Medical School, Boston, Massachusetts, United States
  • Lucia Sobrin
    Massachusetts Eye and Ear, Boston, Massachusetts, United States
    Harvard Medical School, Boston, Massachusetts, United States
  • Joan W Miller
    Massachusetts Eye and Ear, Boston, Massachusetts, United States
    Harvard Medical School, Boston, Massachusetts, United States
  • Alice Lorch
    Massachusetts Eye and Ear, Boston, Massachusetts, United States
    Harvard Medical School, Boston, Massachusetts, United States
  • John B Miller
    Massachusetts Eye and Ear, Boston, Massachusetts, United States
    Harvard Medical School, Boston, Massachusetts, United States
  • Footnotes
    Commercial Relationships   Connor Ross None; Dan Gong None; Nathan Hall None; Tobias Elze None; Lucia Sobrin None; Joan Miller None; Alice Lorch None; John Miller None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 3118. doi:
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      Connor Ross, Dan Gong, Nathan Hall, Tobias Elze, Lucia Sobrin, Joan W Miller, Alice Lorch, John B Miller; Conversion Rates from Non-exudative to Exudative Age-Related Macular Degeneration: An AAO IRIS Registry Analysis. Invest. Ophthalmol. Vis. Sci. 2022;63(7):3118.

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

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Abstract

Purpose : This study examined conversion rates from non-exudative (dry) to exudative (wet) age-related macular degeneration across different patient populations using real-world data from the AAO IRIS Registry (Intelligent Research in Sight).

Methods : A retrospective cohort analysis was conducted using the IRIS Registry spanning 2016-2019. A total of 2,664,789 patients with dry AMD in at least one eye were included in this study. Observed patient characteristics including age, sex, race, geographic region, and smoking status; dry and wet AMD stage; and conversion time from dry to wet AMD. Descriptive statistics and hazard ratios (HRs) from a Cox proportional hazard model were conducted across these characteristics.

Results : Overall conversion rates from dry to wet AMD were 2.0, 6.1, and 6.7% for early, intermediate, and advanced stages respectively (p<0.001). Among those converting to wet AMD, there was decreased risk for males relative to females (HR 0.89, 95% CI [0.88, 0.89]) and Asians (HR 0.52, 95% CI [0.50, 0.54]) or Blacks/African-Americans (HR 0.39, 95% CI [0.37, 0.40]) relative to whites. Relative to patients with bilateral dry AMD, those with wet AMD in one eye and dry in the other eye (HR 5.65, 95% CI [5.56, 5.75] and those with unilateral dry AMD (HR 3.60, 95% CI [3.57, 3.63] had a higher risk of conversion for the eye with dry AMD. Relative to patients with early dry AMD, those with intermediate dry AMD (HR 2.46, 95% CI [2.41, 2.51] and advanced dry AMD (HR 2.69, 95% CI [2.61, 2.77]) had a higher risk of conversion. Among patients with dry AMD in one eye and wet AMD in the other eye, compared with having active choroidal neovascularization in one eye, those with wet AMD with inactive choroidal neovascularization (HR 0.60, 95% CI [0.56, 0.64]) and wet AMD with inactive scar (HR 0.58, 95% CI [0.53, 0.62]) in one eye had a lower risk of conversion to wet AMD in the fellow eye.

Conclusions : In this cohort analysis of the IRIS Registry, females, whites, and smokers had higher risk of conversion from dry to wet AMD. Patients with one eye with wet AMD and one eye with dry AMD and patients with unilateral dry AMD were more likely to convert than patients with bilateral dry AMD. More advanced stages of dry AMD and active choroidal neovascularization in the fellow eye were associated with higher risk of conversion.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

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