Abstract
Purpose :
The aim of this study is to determine if there is a difference in the rate at which symptoms are reported at diagnosis in the first versus second eye to develop neovascular age-related macular degeneration (nAMD).
Methods :
A retrospective chart review identified patients who developed nAMD sequentially (defined as a >30-day gap in diagnosis of each eye). Demographic and clinical characteristics were abstracted from the medical record. Symptoms relatable to nAMD included reduced central vision, visual distortion, increased difficulty adapting to low light levels, needing more light to read or to perform close work, increased difficulty reading printed words, decreased intensity of colors, difficulty recognizing faces, and/or a well-defined blurry spot or blind spot in the central field of vision. In cases where patients could not determine, or did not specify which eye was affected, symptoms were attributed to both eyes. For comparison, patients with sequential nAMD were matched to those who had unilateral nAMD, controlling for age, gender, vision, observation period, and treatment agent.
Results :
47 patients with sequential nAMD were matched with 47 patients with unilateral nAMD. Both groups were equally likely to present with symptoms at the time of diagnosis of their first eye (60% vs. 55%, X2=0.369, p=0.543), but very few patients reported symptoms in their fellow eyes (6.4% vs. 0%, X2=1.044; p= 0.307). Among patients who went on to develop bilateral nAMD, fewer symptoms were reported at diagnosis of the second eye compared with the first eye (34% vs. 60%, X2=6.153, p=0.0131). For comparison, at an equivalent time after the diagnosis of nAMD in unilateral nAMD patients, few patients reported symptoms in their fellow eyes (4.3% vs. 34%, X2=17.1716; p<0.001). And both groups of patients rarely reported symptoms in their fellow eyes at the preceding visit (6.5% vs. 4.3%, X2=0.212; p=0.646).
Conclusions :
Patients with nAMD more commonly present with symptoms at the diagnosis of their first eye. Despite being taught to monitor and report symptoms concerning for nAMD, fewer patients reported symptoms at the time that their second eye was diagnosed with nAMD. This underscores the importance of regular examinations to monitor the fellow eyes of patients with unilateral nAMD to permit early detection of treatable disease.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.