Outcomes of eyes with lesions composed of >50% blood in the Comparison of Age-related Macular Degeneration Treatments Trials (CATT).

Journal Article (Journal Article;Multicenter Study)

OBJECTIVE: To compare baseline characteristics, treatment frequency, visual acuity (VA), and morphologic outcomes of eyes with >50% of the lesion composed of blood (B50 group) versus all other eyes (Other group) enrolled in the Comparison of Age-Related Macular Degeneration Treatments Trials (CATT). DESIGN: Prospective cohort study within a multicenter randomized clinical trial. PARTICIPANTS: CATT patients with neovascular age-related macular degeneration (AMD). METHODS: Treatment for the study eye was assigned randomly to either ranibizumab or bevacizumab and to 3 different dosing regimens over a 2-year period. Reading center graders evaluated baseline and follow-up morphology in color fundus photographs, fluorescein angiography (FA), and optical coherence tomography (OCT). Masked examiners tested VA. MAIN OUTCOME MEASURES: Morphologic features and VA at 1 and 2 years. RESULTS: The B50 group consisted of 84 of 1185 (7.1%) patients enrolled in CATT. Baseline lesion characteristics differed between groups. In the B50 group, choroidal neovascularization size was smaller (0.73 vs 1.83 disc areas [DA]; P < 0.001), total lesion size was greater (4.55 vs 2.31 DA; P <0.001), total retinal thickness was greater (524 vs 455 μm; P = 0.02), and mean VA was worse (56.0 vs 60.9 letters; P = 0.002). Increases in mean VA were similar in the B50 and Other groups at 1 year (+9.3 vs +7.2 letters; P = 0.22) and at 2 years (9.0 vs 6.1 letters; P = 0.17). Eyes treated PRN received a similar number of injections in the 2 groups (12.2 vs 13.4; P = 0.27). Mean lesion size in the B50 group decreased by 1.2 DA at both 1 and 2 years (primarily owing to resolution of hemorrhage) and increased in the Other group by 0.33 DA at 1 year and 0.91 DA at 2 years (P < 0.001). Leakage on FA and fluid on OCT were similar between groups at 1 and 2 years. CONCLUSIONS: In CATT, the B50 group had a visual prognosis similar to the Other group. Lesion size decreased markedly through 2 years. Eyes like those enrolled in CATT with neovascular AMD lesions composed of >50% blood can be managed similarly to those with less or no blood.

Full Text

Duke Authors

Cited Authors

  • Altaweel, MM; Daniel, E; Martin, DF; Mittra, RA; Grunwald, JE; Lai, MM; Melamud, A; Morse, LS; Huang, J; Ferris, FL; Fine, SL; Maguire, MG; Comparison of Age-related Macular Degeneration Treatments Trials (CATT) Research Group, ; Comparison of Age-related Macular Degeneration Treatments Trials CATT Research Group,

Duke Editors

Duke Contributors

Published Date

  • February 2015

Published In

Volume / Issue

  • 122 / 2

Start / End Page

  • 391 - 398.e5

PubMed ID

  • 25307130

Pubmed Central ID

  • PMC4306628

Electronic International Standard Serial Number (EISSN)

  • 1549-4713

Digital Object Identifier (DOI)

  • 10.1016/j.ophtha.2014.08.020


  • eng

Conference Location

  • United States