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

Publication ,  Journal Article
Sharma, S; Toth, CA; Daniel, E; Grunwald, JE; Maguire, MG; Ying, G-S; Huang, J; Martin, DF; Jaffe, GJ ...
Published in: Ophthalmology
April 2016

PURPOSE: To describe the association between morphologic features on fundus photography (FP), fluorescein angiography (FA), and optical coherence tomography (OCT) and visual acuity (VA) in the second year of the Comparison of Age-related Macular Degeneration Treatments Trials (CATT). DESIGN: Prospective cohort study within a randomized clinical trial. PARTICIPANTS: Participants in the CATT. METHODS: Study eye eligibility required angiographic and OCT evidence of choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD) and VA between 20/25 and 20/320. Treatment was assigned randomly to ranibizumab or bevacizumab with 3 different dosing regimens over a 2-year period. MAIN OUTCOME MEASURES: Fluid type, location, and thickness; retina and subretinal tissue complex thickness on OCT; size and lesion composition on FP and FA; and VA. RESULTS: Among 1185 CATT participants, 993 (84%) had fluid on OCT at baseline and completed 2 years of follow-up. At 2 years, intraretinal fluid (IRF), subretinal fluid (SRF), sub-retinal pigment epithelium (RPE) fluid, and subretinal tissue complex thickness decreased in all treatment groups. Ranibizumab monthly was best able to resolve each type of fluid. Eyes with SRF in the foveal center on OCT had better mean VA than eyes with no SRF (72.8 vs. 66.6 letters; P = 0.006). Eyes with IRF in the foveal center had worse mean VA than eyes without IRF (59.9 vs. 70.9 letters; P < 0.0001). Eyes with retinal thickness <120 μm had worse VA compared with eyes with retinal thickness 120 to 212 and >212 μm (59.4 vs. 71.3 vs. 70.3 letters; P < 0.0001). At 2 years, the mean VA (letters) of eyes varied substantially by the type of subfoveal pathology on FP and FA: 70.6 for no pathology; 74.1 for fluid only; 73.3 for CNV or pigment epithelial (RPE) detachment; 68.4 for nongeographic atrophy; and 62.9 for geographic atrophy, hemorrhage, RPE tear, or scar (P < 0.0001). CONCLUSIONS: The associations between VA and morphologic features identified through year 1 were maintained or strengthened during year 2. Eyes with foveal IRF, abnormally thin retina, greater thickness of the subretinal tissue complex on OCT, and subfoveal geographic atrophy or scar on FP/FA had the worst VA. Subretinal fluid was associated with better VA.

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Published In

Ophthalmology

DOI

EISSN

1549-4713

Publication Date

April 2016

Volume

123

Issue

4

Start / End Page

865 / 875

Location

United States

Related Subject Headings

  • Wet Macular Degeneration
  • Visual Acuity
  • Vascular Endothelial Growth Factor A
  • Tomography, Optical Coherence
  • Subretinal Fluid
  • Retinal Pigment Epithelium
  • Ranibizumab
  • Prospective Studies
  • Photography
  • Ophthalmology & Optometry
 

Citation

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Sharma, S., Toth, C. A., Daniel, E., Grunwald, J. E., Maguire, M. G., Ying, G.-S., … Comparison of Age-related Macular Degeneration Treatments Trials Research Group, . (2016). Macular Morphology and Visual Acuity in the Second Year of the Comparison of Age-Related Macular Degeneration Treatments Trials. Ophthalmology, 123(4), 865–875. https://doi.org/10.1016/j.ophtha.2015.12.002
Sharma, Sumit, Cynthia A. Toth, Ebenezer Daniel, Juan E. Grunwald, Maureen G. Maguire, Gui-Shuang Ying, Jiayan Huang, Daniel F. Martin, Glenn J. Jaffe, and Glenn J. Comparison of Age-related Macular Degeneration Treatments Trials Research Group. “Macular Morphology and Visual Acuity in the Second Year of the Comparison of Age-Related Macular Degeneration Treatments Trials.Ophthalmology 123, no. 4 (April 2016): 865–75. https://doi.org/10.1016/j.ophtha.2015.12.002.
Sharma S, Toth CA, Daniel E, Grunwald JE, Maguire MG, Ying G-S, et al. Macular Morphology and Visual Acuity in the Second Year of the Comparison of Age-Related Macular Degeneration Treatments Trials. Ophthalmology. 2016 Apr;123(4):865–75.
Sharma, Sumit, et al. “Macular Morphology and Visual Acuity in the Second Year of the Comparison of Age-Related Macular Degeneration Treatments Trials.Ophthalmology, vol. 123, no. 4, Apr. 2016, pp. 865–75. Pubmed, doi:10.1016/j.ophtha.2015.12.002.
Sharma S, Toth CA, Daniel E, Grunwald JE, Maguire MG, Ying G-S, Huang J, Martin DF, Jaffe GJ, Comparison of Age-related Macular Degeneration Treatments Trials Research Group. Macular Morphology and Visual Acuity in the Second Year of the Comparison of Age-Related Macular Degeneration Treatments Trials. Ophthalmology. 2016 Apr;123(4):865–875.
Journal cover image

Published In

Ophthalmology

DOI

EISSN

1549-4713

Publication Date

April 2016

Volume

123

Issue

4

Start / End Page

865 / 875

Location

United States

Related Subject Headings

  • Wet Macular Degeneration
  • Visual Acuity
  • Vascular Endothelial Growth Factor A
  • Tomography, Optical Coherence
  • Subretinal Fluid
  • Retinal Pigment Epithelium
  • Ranibizumab
  • Prospective Studies
  • Photography
  • Ophthalmology & Optometry