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Five-Year Follow-up of Nonfibrotic Scars in the Comparison of Age-Related Macular Degeneration Treatments Trials.

Publication ,  Journal Article
Daniel, E; Ying, G-S; Kim, BJ; Toth, CA; Ferris, F; Martin, DF; Grunwald, JE; Jaffe, GJ; Dunaief, JL; Pan, W; Maguire, MG ...
Published in: Ophthalmology
May 2019

PURPOSE: To describe changes in visual acuity (VA) and macular morphologic features at 5 years in eyes with nonfibrotic scar (NFS) identified at 1 year in the Comparison of Age-Related Macular Degeneration Treatments Trials (CATT). DESIGN: Prospective cohort study within a randomized clinical trial. PARTICIPANTS: Participants in CATT. METHODS: Participants assigned to ranibizumab or bevacizumab and to 1 of 3 dosing regimens were released from the clinical trial protocol after 2 years and recalled at 5 years. Nonfibrotic scar was identified on color images at year 1 as flat, small, well-circumscribed areas of pigmentation with varying degrees of central hypopigmentation without exposure of underlying choroidal vessels at the site of baseline choroidal neovascularization. Follow-up images were assessed for changes in and around NFS. MAIN OUTCOME MEASURES: Pigmentation changes, VA, development of fibrotic scar (FS), nongeographic atrophy (NGA), geographic atrophy (GA), retinal fluid on OCT, and fluorescein leakage. RESULTS: Among 474 eyes with images obtained at 1, 2, and 5 years, 39 (8.2%) showed NFS at 1 year with a mean VA of 80 letters (Snellen equivalent, 20/25). Among these eyes, FS developed in 5% at 2 years and 28% at 5 years. Nongeographic atrophy was observed in 34%, 47%, and 65% of eyes at 1, 2, and 5 years, respectively. Geographic atrophy developed in 5% of eyes at 2 years and 21% at 5 years. Among eyes with NFS, FS, or no scar at 1 year, mean VA at 5 years was 73 letters (20/32), 48 letters (20/100), and 62 letters (20/63), respectively. At 5 years, NFS eyes demonstrated less GA, less intraretinal fluid, more subretinal fluid, and less subretinal pigment epithelium fluid (all P < 0.01). Among NFS eyes, mean thickness of the retina, subretinal tissue complex, and total retina did not change across years 1 to 5 (P > 0.50). The proportion of eyes with fluid on OCT also did not change (P = 0.36). Subretinal hyperreflective material disappeared by 5 years in 40% of eyes with NFS. CONCLUSIONS: These results indicate that, on average, eyes with NFS after anti-VEGF treatment have good VA not only at 1 and 2 years, but also through 5 years.

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Published In

Ophthalmology

DOI

EISSN

1549-4713

Publication Date

May 2019

Volume

126

Issue

5

Start / End Page

743 / 751

Location

United States

Related Subject Headings

  • Visual Acuity
  • Vascular Endothelial Growth Factor A
  • Treatment Outcome
  • Tomography, Optical Coherence
  • Time Factors
  • Ranibizumab
  • Prospective Studies
  • Prognosis
  • Ophthalmology & Optometry
  • Macular Degeneration
 

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Daniel, E., Ying, G.-S., Kim, B. J., Toth, C. A., Ferris, F., Martin, D. F., … Comparison of Age-Related Macular Degeneration Treatments Trials, . (2019). Five-Year Follow-up of Nonfibrotic Scars in the Comparison of Age-Related Macular Degeneration Treatments Trials. Ophthalmology, 126(5), 743–751. https://doi.org/10.1016/j.ophtha.2018.11.020
Daniel, Ebenezer, Gui-Shuang Ying, Benjamin J. Kim, Cynthia A. Toth, Frederick Ferris, Daniel F. Martin, Juan E. Grunwald, et al. “Five-Year Follow-up of Nonfibrotic Scars in the Comparison of Age-Related Macular Degeneration Treatments Trials.Ophthalmology 126, no. 5 (May 2019): 743–51. https://doi.org/10.1016/j.ophtha.2018.11.020.
Daniel E, Ying G-S, Kim BJ, Toth CA, Ferris F, Martin DF, et al. Five-Year Follow-up of Nonfibrotic Scars in the Comparison of Age-Related Macular Degeneration Treatments Trials. Ophthalmology. 2019 May;126(5):743–51.
Daniel, Ebenezer, et al. “Five-Year Follow-up of Nonfibrotic Scars in the Comparison of Age-Related Macular Degeneration Treatments Trials.Ophthalmology, vol. 126, no. 5, May 2019, pp. 743–51. Pubmed, doi:10.1016/j.ophtha.2018.11.020.
Daniel E, Ying G-S, Kim BJ, Toth CA, Ferris F, Martin DF, Grunwald JE, Jaffe GJ, Dunaief JL, Pan W, Maguire MG, Comparison of Age-Related Macular Degeneration Treatments Trials. Five-Year Follow-up of Nonfibrotic Scars in the Comparison of Age-Related Macular Degeneration Treatments Trials. Ophthalmology. 2019 May;126(5):743–751.
Journal cover image

Published In

Ophthalmology

DOI

EISSN

1549-4713

Publication Date

May 2019

Volume

126

Issue

5

Start / End Page

743 / 751

Location

United States

Related Subject Headings

  • Visual Acuity
  • Vascular Endothelial Growth Factor A
  • Treatment Outcome
  • Tomography, Optical Coherence
  • Time Factors
  • Ranibizumab
  • Prospective Studies
  • Prognosis
  • Ophthalmology & Optometry
  • Macular Degeneration