TY - JOUR
T1 - The impact of disease activity on 5-year outcomes in patients undergoing treatment for neovascular age-related macular degeneration
AU - Teo, Kelvin Yi Chong
AU - Nguyen, Vuong
AU - Cheung, Chui Ming Gemmy
AU - Arnold, Jennifer J.
AU - Chen, Fred K.
AU - Barthelmes, Daniel
AU - Gillies, Mark C.
N1 - Funding Information:
Supported by a grant from the Royal Australian NZ College of Ophthalmologists Eye Foundation (2007–2009), a grant from the National Health and Medical Research Council, Australia (NHMRC 2010–2012) and a grant from the Macula Disease Foundation, Australia. M. C. Gillies is a Sydney Medical Foundation Fellow and is supported by an NHMRC practitioner fellowship. D. Barthelmes was supported by the Walter and Gertrud Siegenthaler Foundation Zurich, Switzerland and the Swiss National Foundation. C. M. Gemmy Cheung is supported grant by a grant from the National Medical Research Council, (Open Fund Large Collaborative grant no: NMRC/LCG/0042018). F. K. Chen is supported by an NHMRC/Medical Research Future Fund career development fellowship (MRF1142962). Funding was also provided by Novartis and Bayer. Novartis made non-binding comments on the design of the study.
Publisher Copyright:
© 2022 Lippincott Williams and Wilkins. All rights reserved.
PY - 2022/1/1
Y1 - 2022/1/1
N2 - Purpose: To assess the impact of disease activity on clinical outcomes in a "real-world" cohort with neovascular age-related macular degeneration over 5 years. Methods: Data were obtained from the prospectively defined Fight Retinal Blindness! registry. Eyes were divided into tertiles based on the proportion of visits where choroidal neovascular lesion was active (low, moderate, and high) up until 5 years. Results: Data from 2,109 eyes were included. The adjusted mean (95% confidence interval) visual acuity change was 20.5 letters (21.8 to 1.1), 1.8 letters (0.2 to 3.4), and 22.5 letters (24.2 to 21.3) in the low, moderate, and high activity groups respectively, P , 0.001. Eyes in the low activity group were more likely to develop macular atrophy (56, 47 and 26% in the low, moderate, and high activity groups respectively, P , 0.001) but less likely to develop subretinal fibrosis (27, 35 and 42% in the low, moderate, and high activity groups respectively, P , 0.001). Conclusion: Eyes with higher and lower levels of disease activity had poorer outcomes than eyes with moderate activity over 5 years, apparently because of the development of subretinal fibrosis or macular atrophy.
AB - Purpose: To assess the impact of disease activity on clinical outcomes in a "real-world" cohort with neovascular age-related macular degeneration over 5 years. Methods: Data were obtained from the prospectively defined Fight Retinal Blindness! registry. Eyes were divided into tertiles based on the proportion of visits where choroidal neovascular lesion was active (low, moderate, and high) up until 5 years. Results: Data from 2,109 eyes were included. The adjusted mean (95% confidence interval) visual acuity change was 20.5 letters (21.8 to 1.1), 1.8 letters (0.2 to 3.4), and 22.5 letters (24.2 to 21.3) in the low, moderate, and high activity groups respectively, P , 0.001. Eyes in the low activity group were more likely to develop macular atrophy (56, 47 and 26% in the low, moderate, and high activity groups respectively, P , 0.001) but less likely to develop subretinal fibrosis (27, 35 and 42% in the low, moderate, and high activity groups respectively, P , 0.001). Conclusion: Eyes with higher and lower levels of disease activity had poorer outcomes than eyes with moderate activity over 5 years, apparently because of the development of subretinal fibrosis or macular atrophy.
KW - AMD
KW - Anti-VEGF
KW - Macular atrophy
KW - nAMD
KW - Real world
KW - Sub retinal fibrosis
UR - http://www.scopus.com/inward/record.url?scp=85122366747&partnerID=8YFLogxK
U2 - 10.1097/IAE.0000000000003267
DO - 10.1097/IAE.0000000000003267
M3 - Article
C2 - 34292225
AN - SCOPUS:85122366747
SN - 0275-004X
VL - 42
SP - 95
EP - 106
JO - Retina
JF - Retina
IS - 1
ER -