Potential Public Health Impact of Age-Related Eye Disease Study Results

Bressler, N. M.; Sb, Bressler; Congdon, N.; Ferris, Frederick L.; Friedman, DS; Klein, Ronald; As, Lindblad; Rc, Milton; Jm, Seddon

doi:10.1001/archopht.121.11.1621

Cited by 317 publications

(64 citation statements)

References 3 publications

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“…Until anti-vascular endothelial growth factor (VEGF) therapy became available and was demonstrated to significantly increase the functional outcome in patients with neovascular age-related macular degeneration (AMD) [1,2], AMD was considered the leading cause of blindness in the elderly in the developed world [3]. Recently, high resolution imaging instruments such as spectral domain optical coherence tomography (SD-OCT) became available to help us better understand the pathophysiology, morphology and structure-function relationships in this complex disease.…”

Section: Introductionmentioning

confidence: 99%

Relationship between Visual Acuity and Spectral Domain Optical Coherence Tomography Retinal Parameters in Neovascular Age-Related Macular Degeneration

Ristau

Keane²,

Walsh³

et al. 2013

Ophthalmologica

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Purpose: Relationship between spectral domain optical coherence tomography (SD-OCT) and visual acuity (VA) in neovascular age-related macular degeneration (NVAMD). Procedures: VA and SD-OCTs of 64 treatment-naive eyes with NVAMD were retrospectively collected at baseline and 1 year (n = 30). Retinal and subretinal spaces were manually analyzed. Volume and thickness measurements were correlated with VA. Results: At baseline, lower VA correlated with increased volume of subretinal hyperreflective material (R = 0.4, p < 0.001) and with decreased volume of the photoreceptor layer (PRL, R = -0.4, p < 0.01). At 1 year, lower VA correlated with decreased volume of the retina (R = -0.7, p < 0.001), outer nuclear layer (R = -0.6, p < 0.05) and PRL (R = -0.7, p < 0.001). Decrease in VA after 1 year correlated with a decrease in PRL (R = 0.4, p < 0.05). Conclusions: Quantitative analysis of SD-OCT revealed correlations between VA and retinal and subretinal morphological changes in NVAMD. Message: Atrophy of the outer retina is an important correlate for lower VA in NVAMD.

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Section: Introductionmentioning

confidence: 99%

Relationship between Visual Acuity and Spectral Domain Optical Coherence Tomography Retinal Parameters in Neovascular Age-Related Macular Degeneration

Ristau

Keane²,

Walsh³

et al. 2013

Ophthalmologica

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“…Age-related macular degeneration (AMD) is the leading cause of severe blindness in the elderly in Western countries [11,13]. Exudative macular degeneration is the most severe form with the highest risk of blindness [13].…”

Section: Introductionmentioning

confidence: 99%

A systematic review on the effect of bevacizumab in exudative age-related macular degeneration

Schouten

Heij

Webers

et al. 2008

Graefes Arch Clin Exp Ophthalmol

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Aim To provide evidence for the effect of bevacizumab on visual acuity (VA) and central retinal thickness (CRT) in exudative age-related macular degeneration Methods A systematic review of all articles of bevacizumab for exudative AMD was conducted. Articles published up to March 2008 were identified in Medline, Embase, the Cochrane Controlled Trials Register and references from included articles. Search terms were "Bevacizumab or Avastin" and "Macula* or ARMD or AMD or intra(-) vitreal or intra(-)vitreous". Three observers participated in the data retrieval and assignment of the quality scores. Results A total of 561 articles were retrieved. Three randomised controlled trials (RCT) and 23 before-and-after studies of patients (n=1,435) who had received bevacizumab were published. Inclusion criteria varied. Lack of masking was the main methodological shortcoming. These RCTs showed that bevacizumab is more effective than PDT. Bevacizumab was given intravenously or as intravitreal injection. The latter was given once, or repeatedly every 4 weeks, and with or without additional injection when a recurrence occurred, mostly based on visual acuity and/or findings from optical coherence tomography. After intravenous administration, the weighted mean change in VA was +12.8 ETDRS letters (range +11 to +14) and the weighted mean change for CRT was −129 μm (range −100 to −202). For the 23 studies with intravitreal injections, the change in VA was +8.6 letters (range +2 to +26) and the change in CRT was −90 μm (range −46 to −190). The incidence of adverse events was low. The change in VA was 2.7 letters higher for studies with a higher quality vs lower quality. Conclusion Visual acuity improves and central retinal thickness decreases in patients with exudative AMD after bevacizumab. There is no reasonable doubt that this is caused by bevacizumab. It is likely that a randomised controlled trial will show that bevacizumab is equivalent in effect to ranibizumab, which showed a change in ETDRS of +5.9 letters for occult or minimally classic CNV and +9.8 letters for classic CNV after three monthly injections in two large RCTs.

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“…Neovascular age-related macular degeneration (nAMD) is the leading cause of irreversible central visual loss in older adults [1,2]. Submacular hemorrhage secondary to choroidal neovascularization (CNV) is not uncommon in nAMD patients [3,4,5] with a prevalence of roughly 5-6% [6] and may be responsible for a sudden vision loss [7].…”

Section: Introductionmentioning

confidence: 99%

Intravitreal Ranibizumab for Predominantly Hemorrhagic Choroidal Neovascularization in Age-Related Macular Degeneration

et al. 2015

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Purpose: To evaluate the effects of intravitreal ranibizumab monotherapy on predominantly hemorrhagic choroidal neovascularization with foveal involvement associated with age-related macular degeneration. Materials and Methods: Twenty-two consecutive eyes with hemorrhagic neovascularization were treated with 3 monthly intravitreal ranibizumab injections. Additional injections were administered according to retreatment criteria during 12 months of follow-up. Results: A mean of 6.64 ± 1.36 injections was administered. Overall, the mean visual acuity increased from 10.90 ± 6.02 to 12.81 ± 8.34 ETDRS letters (p > 0.05) at 12 months. The ‘early treatment group' gained a mean of 2.83 ± 2.24 ETDRS letters (p < 0.05), while the ‘late treatment group' gained a mean of 0.30 ± 1.25 ETDRS letters (p > 0.05) with significant differences between the groups (p < 0.05). A progressive resolution of macular bleeding was registered in 20 patients (mean time: 5.3 ± 1.6 months). Conclusions: Ranibizumab injections can be considered a beneficial approach for the management of predominantly hemorrhagic choroidal neovascularization with foveal involvement associated with age-related macular degeneration. Furthermore, the time interval between hemorrhage and the first injection seems to be an important predicting factor of final visual acuity.

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Potential Public Health Impact of Age-Related Eye Disease Study Results

Cited by 317 publications

References 3 publications

Relationship between Visual Acuity and Spectral Domain Optical Coherence Tomography Retinal Parameters in Neovascular Age-Related Macular Degeneration

Relationship between Visual Acuity and Spectral Domain Optical Coherence Tomography Retinal Parameters in Neovascular Age-Related Macular Degeneration

A systematic review on the effect of bevacizumab in exudative age-related macular degeneration

Intravitreal Ranibizumab for Predominantly Hemorrhagic Choroidal Neovascularization in Age-Related Macular Degeneration

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