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Five-Year Outcomes with Anti-Vascular Endothelial Growth Factor Treatment of Neovascular Age-Related Macular Degeneration: The Comparison of Age-Related Macular Degeneration Treatments Trials.

Publication ,  Journal Article
Comparison of Age-related Macular Degeneration Treatments Trials (CATT) Research Group; Maguire, MG; Martin, DF; Ying, G-S; Jaffe, GJ; Daniel, E ...
Published in: Ophthalmology
August 2016

PURPOSE: To describe outcomes 5 years after initiating 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. METHODS: Patients were assigned randomly to ranibizumab or bevacizumab and to 1 of 3 dosing regimens. After 2 years, patients were released from the clinical trial protocol. At 5 years, patients were recalled for examination. MAIN OUTCOME MEASURES: Visual acuity (VA) and morphologic retinal features. RESULTS: Visual acuity was obtained for 647 of 914 (71%) living patients with average follow-up of 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 was 15.4. Most patients (60%) were treated 1 time or more with a drug other than their assigned drug. At the 5-year visit, 50% of eyes had VA of 20/40 or better and 20% had VA of 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 mm(2), a mean of 4.8 mm(2) larger than at 2 years. Geographic atrophy was present in 213 of 515 (41%) gradable eyes and was subfoveal in 85 eyes (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. The retina was abnormally thin (<120 μm) in 36% of eyes. 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 morphologic outcomes between drug or regimen groups. CONCLUSIONS: Vision gains during the first 2 years were not maintained at 5 years. However, 50% of eyes had VA of 20/40 or better, confirming anti-vascular endothelial growth factor therapy as a major long-term therapeutic advance for neovascular AMD.

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Published In

Ophthalmology

DOI

EISSN

1549-4713

Publication Date

August 2016

Volume

123

Issue

8

Start / End Page

1751 / 1761

Location

United States

Related Subject Headings

  • Wet Macular Degeneration
  • Visual Acuity
  • Vascular Endothelial Growth Factor A
  • Treatment Outcome
  • Tomography, Optical Coherence
  • Subretinal Fluid
  • Retina
  • Ranibizumab
  • Prospective Studies
  • Ophthalmology & Optometry
 

Citation

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Comparison of Age-related Macular Degeneration Treatments Trials (CATT) Research Group, Maguire, M. G., Martin, D. F., Ying, G.-S., Jaffe, G. J., Daniel, E., … Fine, S. L. (2016). Five-Year Outcomes with Anti-Vascular Endothelial Growth Factor Treatment of Neovascular Age-Related Macular Degeneration: The Comparison of Age-Related Macular Degeneration Treatments Trials. Ophthalmology, 123(8), 1751–1761. https://doi.org/10.1016/j.ophtha.2016.03.045
Comparison of Age-related Macular Degeneration Treatments Trials (CATT) Research Group, Maureen G. Maguire, Daniel F. Martin, Gui-Shuang Ying, Glenn J. Jaffe, Ebenezer Daniel, Juan E. Grunwald, Cynthia A. Toth, Frederick L. Ferris, and Stuart L. Fine. “Five-Year Outcomes with Anti-Vascular Endothelial Growth Factor Treatment of Neovascular Age-Related Macular Degeneration: The Comparison of Age-Related Macular Degeneration Treatments Trials.Ophthalmology 123, no. 8 (August 2016): 1751–61. https://doi.org/10.1016/j.ophtha.2016.03.045.
Comparison of Age-related Macular Degeneration Treatments Trials (CATT) Research Group, Maguire MG, Martin DF, Ying G-S, Jaffe GJ, Daniel E, et al. Five-Year Outcomes with Anti-Vascular Endothelial Growth Factor Treatment of Neovascular Age-Related Macular Degeneration: The Comparison of Age-Related Macular Degeneration Treatments Trials. Ophthalmology. 2016 Aug;123(8):1751–61.
Comparison of Age-related Macular Degeneration Treatments Trials (CATT) Research Group, et al. “Five-Year Outcomes with Anti-Vascular Endothelial Growth Factor Treatment of Neovascular Age-Related Macular Degeneration: The Comparison of Age-Related Macular Degeneration Treatments Trials.Ophthalmology, vol. 123, no. 8, Aug. 2016, pp. 1751–61. Pubmed, doi:10.1016/j.ophtha.2016.03.045.
Comparison of Age-related Macular Degeneration Treatments Trials (CATT) Research Group, Maguire MG, Martin DF, Ying G-S, Jaffe GJ, Daniel E, Grunwald JE, Toth CA, Ferris FL, Fine SL. Five-Year Outcomes with Anti-Vascular Endothelial Growth Factor Treatment of Neovascular Age-Related Macular Degeneration: The Comparison of Age-Related Macular Degeneration Treatments Trials. Ophthalmology. 2016 Aug;123(8):1751–1761.
Journal cover image

Published In

Ophthalmology

DOI

EISSN

1549-4713

Publication Date

August 2016

Volume

123

Issue

8

Start / End Page

1751 / 1761

Location

United States

Related Subject Headings

  • Wet Macular Degeneration
  • Visual Acuity
  • Vascular Endothelial Growth Factor A
  • Treatment Outcome
  • Tomography, Optical Coherence
  • Subretinal Fluid
  • Retina
  • Ranibizumab
  • Prospective Studies
  • Ophthalmology & Optometry