Macular Morphology and Visual Acuity in the Second Year of the Comparison of Age-Related Macular Degeneration Treatments Trials

Sharma, Sumit; Toth, Cynthia A.; Daniel, Ebenezer; Grunwald, Juan E.; Maguire, Maureen G.; Ying, Gui‐Shuang; Huang, Jiayan; Martín, Daniel; Jaffe, Glenn J.

doi:10.1016/j.ophtha.2015.12.002

Cited by 182 publications

(178 citation statements)

References 10 publications

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“…SHRM has been associated with a poor visual outcome and increased scar formation in an analysis of the participants in the CATT study 20. However, further analysis of this CATT cohort demonstrated that eyes with RAP lesions developed less SHRM and scarring but a greater rate of geographic atrophy24 versus eyes with other lesion types.…”

Section: Discussionmentioning

confidence: 86%

Type 3 neovascularisation: long-term analysis of visual acuity and optical coherence tomography anatomical outcomes

et al. 2018

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Section: Discussionmentioning

confidence: 86%

Type 3 neovascularisation: long-term analysis of visual acuity and optical coherence tomography anatomical outcomes

et al. 2018

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“…We previously reported that retinal thinning to <120 microns was associated with worse VA outcomes at 1 and 2 years. 36,37 The proportion of eyes with an abnormally thin retina increased from 22% at the end of Year 2 to 36% at 5 years. 37 We also previously reported that the proportion of eyes with geographic atrophy was 20% at 2 years and this proportion increased to 41% at 5 years, with an increase in subfoveal geographic atrophy from 6% to 17%.…”

Section: Discussionmentioning

confidence: 97%

Five-Year Outcomes with Anti–Vascular Endothelial Growth Factor Treatment of Neovascular Age-Related Macular Degeneration

et al. 2016

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Purpose To describe outcomes 5 years after initiation of treatment with bevacizumab or ranibizumab for neovascular age-related macular degeneration (AMD). Design Cohort study.. Participants Patients enrolled in the Comparison of AMD Treatments Trials (CATT). Methods Patients were randomly assigned to ranibizumab or bevacizumab and to 1 of 3 dosing regimens. After 2 years, patients were released from the clinical trial protocol. At approximately 5 years, patients were recalled for examination. Main Outcome Measures Visual acuity (VA) and morphologic retinal features. Results VA was obtained for 647 (71%) of 914 living patients with average follow-up time 5.5 years. The mean number of examinations for AMD care after the clinical trial ended was 25.3, and the mean number of treatments in the study eye was 15.4. Most (60%) patients were treated ≥1 times with a drug other than their randomly assigned drug. At the 5-year visit, 50% of study eyes had VA 20/40 or better and 20% had VA 20/200 or worse. Mean change in VA was −3 letters from baseline and −11 letters from 2 years. Among 467 eyes with fluorescein angiography, mean total lesion area was 12.9 mm2, a mean of 4.8 mm2 larger than at 2 years. Geographic atrophy was present in 213 (41%) of 515 gradable eyes and was subfoveal in 85 (17%). Among 555 eyes with spectral domain optical coherence tomography, 83% had fluid (61% intraretinal, 38% subretinal, and 36% sub-retinal pigment epithelium). Mean foveal total thickness was 278 μm; a decrease of 182 μm from baseline and 20 μm from 2 years. An abnormally thin retina at the foveal center (<120 μm) was present in 36%. Between 2 and 5 years, the group originally assigned to ranibizumab for 2 years lost more VA than the bevacizumab group (−4 letters; p=0.008). Otherwise, there were no statistically significant differences in VA or morphological outcomes between drug or regimen groups. Conclusion Vision gains during the first 2 years of the trial were not maintained at 5 years. However, 50% of eyes had VA 20/40 or better, confirming anti-VEGF therapy as a major long-term therapeutic advance for neovascular AMD.

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“…The presence of IRF is a hallmark of more advanced or perhaps chronic disease, indicating possible irreversible neurosensory damage 56. Indeed, the presence of IRF at baseline was associated with worse VA at 2 years in the Comparison of AMD Treatment Trial (CATT) study 57. Similarly, the VEGF Trap-Eye: Investigation of Efficacy and Safety in Wet AMD (VIEW 1 and VIEW 2) data suggested that eyes with baseline IRF had worse VA at week 52 than those without IRF 18,55.…”

Section: Discussionmentioning

confidence: 99%

Two-year outcome of treat-and-extend aflibercept after ranibizumab in age-related macular degeneration and polypoidal choroidal vasculopathy patients

Azuma¹,

Asaoka²,

Matsuda³

et al. 2018

OPTH

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BackgroundThe purpose of the study was to evaluate the 2-year outcome and predictive factors of treat-and-extend aflibercept in patients with eyes affected by typical neovascular age-related macula degenelation (t-AMD) or polypoidal choroidal vasculopathy (PCV), who were switched from ranibizumab.Patients and methodsThe patients underwent three monthly aflibercept injections and subsequent administration following the treat-and-extend protocol. Sixty-two eyes of 62 patients were reviewed retrospectively. R statistical software was used for statistical analysis.ResultsTwenty-two eyes were t-AMD and the remaining 40 eyes were PCV. There was no significant difference in the logarithm of the minimal angle of resolution visual acuity (VA) between baseline and 2 years after switching to aflibercept (0.40 vs 0.40; P=0.99). Multivariate analyses suggested that the following factors were significantly correlated with better VA at 2 years after switching to aflibercept: patients with PCV, the absence of intraretinal fluid at baseline, and better VA at baseline.ConclusionIn conclusion, VA was maintained and there was an anatomical improvement at 2 years in patients with t-AMD and PCV who were switched from ranibizumab to treat-and-extend aflibercept. PCV patients showed more favorable visual outcomes and less injections at 2 years compared to t-AMD patients. Intraretinal fluid and VA at baseline were predictors of VA at 2 years.

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Macular Morphology and Visual Acuity in the Second Year of the Comparison of Age-Related Macular Degeneration Treatments Trials

Cited by 182 publications

References 10 publications

Type 3 neovascularisation: long-term analysis of visual acuity and optical coherence tomography anatomical outcomes

Type 3 neovascularisation: long-term analysis of visual acuity and optical coherence tomography anatomical outcomes

Five-Year Outcomes with Anti–Vascular Endothelial Growth Factor Treatment of Neovascular Age-Related Macular Degeneration

Two-year outcome of treat-and-extend aflibercept after ranibizumab in age-related macular degeneration and polypoidal choroidal vasculopathy patients

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