Abstract
Purpose :
This study aims to investigate the progression of dry age related macular degeneration (AMD) afflicted eyes into neo-vascular AMD and discern the influencing factors
Methods :
Retrospective data were extracted from electronic health records (EHR) at the University of Pittsburgh Medical Campus (UPMC). The date of initial diagnosis of dry AMD in the eye marked as the index year for the analysis. The year of clinical diagnosis of wet AMD is considered as the conversion year. The study spanned from October 5, 2006, to July 30, 2023. The exclusion criteria comprised monocular patients at their initial visit. Among the 123 eligible eyes, 104 presented with dry AMD at the baseline. Factors like age, gender, smoking habits, no of injections, systemic diseases and past ocular diseases like glaucoma were studied to assess their influence over progression
Results :
The eyes were split into four groups based on the time it took to develop wet AMD: Group 1 within 5 years, Group 2 between 5-10 years, Group 3 between 10-15 years, and Group 4 not converting by the study's conclusion (Figure 1). Out of 104 dry AMD eyes, 49 converted to wet AMD, the average time taken to develop wet AMD was 7.4 years. The average age at presentation was 71.16 for converted eyes and 66.75 for non-converted, a statistically significant difference (t-Test, p-value: 0.017). Survival analysis indicated a 52.88% survival probability for dry AMD eyes by the study's conclusion. A mixed linear model regression showed smokers had worse visual acuity (VA) (+0.21 logMAR) than non-smokers (p-value: 0.019). Female smokers had more significant visual acuity decline than male smokers (Figure 2). Visual acuity worsened more for the converted group (from 0.15 to 0.87, 6 times worse) than the non-converted group (from 0.14 to 0.43, 3 times worse). A chi-square test between smokers and non-smokers and conversion to wet AMD did not show any statistical significance
Conclusions :
Our analysis revealed that female smokers experienced a more noticeable decline in visual acuity compared to male smokers over time. While smoking didn't affect the likelihood of developing wet AMD, smokers, in general, had markedly poorer visual acuity than non-smokers. Additionally, baseline systemic conditions such as hypertension, diabetes, and the number of injections did not influence the progression
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.