Improvement of Visual Acuity Over Time in Patients With Bilateral Geographic Atrophy From Age-Related Macular Degeneration

Sunness, Janet S.; Applegate, Carol A.; González-Barón, Joel

doi:10.1097/00006982-200002000-00009

Cited by 46 publications

(30 citation statements)

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“…SLO perimetry revealed an area denuded of RPE at the posterior pole. In [32,33]. Similar observations are reported after removal of submacular CNV [13,19].…”

Section: Fixationsupporting

confidence: 84%

“…Patients with subfoveal RPE defects prefer to fixate extrafoveally, namely at the margin of the defect, as documented for 31 eyes (55%) in our series. Similarly, patients with geographic atrophy fixate extrafoveally, at the margin of the atrophy zone, independent from its size [33]. Therefore, fixation in the area of RPE atrophy after IPE translocation in this study may signal a protective effect of IPE on retinal photoreceptors over 1 year.…”

Section: Fixationmentioning

confidence: 58%

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Translocation of iris pigment epithelium in patients with exudative age-related macular degeneration — long term results

Lappas¹,

Foerster²,

Weinberger³

et al. 2004

The Macula

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Purpose: To report the practicability and efficacy of autologous iris pigment epithelium (IPE) translocation in exudative age-related macular degeneration (ARMD) over 1 year. Methods: The consecutive interventional case series included 56 patients with exudative ARMD. During vitrectomy the submacular neovascular membrane (CNV) was removed and IPE cells, harvested from a peripheral iridectomy, were injected into the submacular space. Included were patients with subfoveal occult CNV (11 eyes), classic CNV (10 eyes), mixed CNV (17 eyes), CNV with a pigment epithelial detachment (13 eyes) or CNV with a hemorrhage (5 eyes). Outcome measures were visual acuity, foveal fixation, size of CNV and rate of recurrence based on fluorescence angiographic imaging. Results: All patients underwent successful surgical removal of the CNV with consecutive subretinal IPE injection.

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“…SLO perimetry revealed an area denuded of RPE at the posterior pole. In [32,33]. Similar observations are reported after removal of submacular CNV [13,19].…”

Section: Fixationsupporting

confidence: 84%

Section: Fixationmentioning

confidence: 58%

Translocation of iris pigment epithelium in patients with exudative age-related macular degeneration — long term results

Lappas¹,

Foerster²,

Weinberger³

et al. 2004

The Macula

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show abstract

“…Sunness et al [18] have demonstrated in a larger GA cohort that central VA poorly correlated with total lesion size in the presence of ‘foveal sparing' and that a dramatic drop in VA occurs once the fovea becomes involved [17]. After loss of vision due to development of atrophy in the fovea, spontaneous VA improvement may be observed in the further course of the disease due to delayed change of the preferred location of fixation to eccentric macula areas.…”

Section: Introductionmentioning

confidence: 99%

Modeling Visual Acuity in Geographic Atrophy Secondary to Age-Related Macular Degeneration

Schmitz-Valckenberg¹,

Nadal

Fimmers

et al. 2016

Ophthalmologica

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Purpose: To analyze and model visual acuity (VA) in geographic atrophy (GA) secondary to age-related macular degeneration (AMD). Methods: The course of VA was analyzed using Turnbull's estimator in 226 eyes with uni- or bilateral GA due to AMD (151 patients; mean age 74.0 ± 7.6 years; mean follow-up time 33.4 ± 23.4 months) from the natural history FAM (Fundus-Autofluorescence Imaging in AMD) study. The variables ‘age at baseline', ‘gender', ‘lesion size', ‘diagnosis of the fellow eye', ‘status of the fovea', ‘focality of the lesion' and ‘pattern' were evaluated for effects on predicting VA using linear mixed-effects models. Results: Mean VA at baseline was0.6 (Snellen 20/80) ± 0.4 logMAR [range -0.1 to 1.8 (20/17 to hand motions)], showing an estimated mean increase of 0.181 (95% CI 0.152-0.210) and 0.256 (0.214-0.300) after 2 and 4 years of follow-up, respectively. The percentage of eyes with a loss of ≥3 lines was 34% by 2 years and 47% by 4 years. Linear mixed model analysis suggested that 65% of VA variability could be explained by the assessed predictor variables. The strongest effect was found for the ‘status of the fovea' (0.69 logMAR units between ‘definitively spared fovea' and ‘definitive foveal involvement', p < 0.001). The second strongest effect was identified for ‘total lesion size' (effects between 0.02 and 0.09 logMAR units for each mm depending on foveal involvement, p < 0.001, square root transformed values). Conclusions: These findings underscore the importance of GA lesion characteristics as these have the strongest impact on VA. Natural history data and modeling VA to other variables will be helpful for refining outcome parameters and estimating possible benefits of therapeutic interventions.

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“…Improvements in visual acuity were observed, but linking these improvements to therapeutic efficacy can be challenging under some circumstances, given that spontaneously improved visual acuity in the face of worsening macular degeneration has been described (Sunness et al, 2000(Sunness et al, , 2014.…”

Section: Box 1 the Regulatory Path From The Lab To The Clinicmentioning

confidence: 99%

The advancement of human pluripotent stem cell-derived therapies into the clinic

Thies

Murry

2015

Development

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Human pluripotent stem cells (hPSCs) offer many potential applications for drug screening and 'disease in a dish' assay capabilities. However, a more ambitious goal is to develop cell therapeutics using hPSCs to generate and replace somatic cells that are lost as a result of disease or injury. This Spotlight article will describe the state of progress of some of the hPSC-derived therapeutics that offer the most promise for clinical use. Lessons from developmental biology have been instrumental in identifying signaling molecules that can guide these differentiation processes in vitro, and will be described in the context of these cell therapy programs.

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Improvement of Visual Acuity Over Time in Patients With Bilateral Geographic Atrophy From Age-Related Macular Degeneration

Cited by 46 publications

References 0 publications

Translocation of iris pigment epithelium in patients with exudative age-related macular degeneration — long term results

Translocation of iris pigment epithelium in patients with exudative age-related macular degeneration — long term results

Modeling Visual Acuity in Geographic Atrophy Secondary to Age-Related Macular Degeneration

The advancement of human pluripotent stem cell-derived therapies into the clinic

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