Abstract
Purpose :
To assess visual acuity (VA) changes and rate of neovascular AMD (nAMD) diagnosis in patients with geographic atrophy (GA).
Methods :
A retrospective study was completed using the Vestrum Health Retina Database. Eligible patients were those diagnosed with nonexudative AMD with advanced atrophy (with and without subfoveal involvement), without a diagnosis of neovascular AMD (nAMD) prior or at the GA diagnosis date, in at least 1 eye. Patients were evaluated between January 2014 to August 2022 with at least 3 years of follow up.
Results :
There were 23,730 GA patient eyes with at least 3 years of follow up, and 4,972 were excluded due to a diagnosis of nAMD prior to, or on, the GA diagnosis date, resulting in 18,712 GA patient eyes. Mean baseline age was 79.3 years and 66% were women. During follow-up, 25% of eyes were diagnosed with nAMD, at 24.7 months on average (8.8% in year 1, 5.9% in year 2, 4.6% in year 3, and 6.3% beyond year 3). In those 11,125 GA eyes which remained without nAMD and had valid VA readings through follow-up, mean VA measured 59.5 letters at baseline, with a loss of 3.1 letters at year 1 (P<0.0001, 95% confidence interval (CI) 2.8 – 3.3 letters). Similarly, in 9,725 GA eyes, there was a loss of 6.4 letters at year 2 (P<0.0001, 95% CI 6.1 – 6.8 letters), and in 8,870 eyes, there was a loss of 10.1 letters at year 3 (P<0.0001, 95% CI 9.6 – 10.5 letters). When stratified by baseline VA (≥ 20/40, <20/40-20/100, <20/100-20/200, <20/200), eyes with VA <20/40-20/100 lost more letters than others. Mean CST in 1,505 eyes measured 253.1 um at baseline, with a loss of 2.7 um at year 1, 4.7 um at year 2 (1,318 eyes), and 8.3 um at year 3 (1,251 eyes).
Conclusions :
GA is associated with meaningful disease burden. Eyes with GA lost 2 lines of vision at year 3. Those GA eyes with modest VA impairment at baseline may be at the greatest risk of further vision loss, likely from progression to subfoveal GA. Eyes with GA are also at meaningful risk of nAMD.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.