Daniel Barthelmes1, Richard Walton2, Anna E Campain2, Judy M Simpson3, Jennifer J Arnold4, Ian L McAllister5, Robyn H Guymer6, Alex P Hunyor7, Rohan W Essex8, Nigel Morlet9, Mark C Gillies2. 1. The Save Sight Institute, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia Department of Ophthalmology, University Hospital Zurich, University of Zurich, Zurich, Switzerland. 2. The Save Sight Institute, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia. 3. Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia. 4. Marsden Eye Specialists, Parramatta, New South Wales, Australia. 5. The Lions Eye Institute, Perth, Western Australia, Australia. 6. Center for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia. 7. The Save Sight Institute, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia Retina Associates, Chatswood, New South Wales, Australia. 8. Department of Ophthalmology, Canberra Hospital, Garran, Australian Capital Territory, Australia. 9. Department of Population Health, University of Western Australia, Perth, Western Australia, Australia.
Abstract
AIM: To describe outcomes of eyes with wet age-related macular degeneration (AMD) subdivided by lesion activity in a large multicentre cohort study. METHODS: Treatment-naive eyes with subfoveal choroidal neovascularisation receiving antivascular endothelial growth factor therapy enrolled in the Fight Retinal Blindness observational study were included. Lesions were graded at each visit as active if there was intraretinal or subretinal fluid attributable to leak from choroidal neovascularisation lesion or fresh haemorrhage. Eyes were divided into four groups; based on the proportion of visits, each eye was graded as active during the first 12 months of treatment (persistent, high, moderate and low activity). RESULTS: 655 eyes were included. Similar mean visual acuity changes compared with baseline were observed in all four groups at 12 months (+6.8, +8.3, +6.2 and +5.5 letters for the low, moderate, high and persistent groups, respectively; p<0.001 for each group). The mean number of injections given increased only modestly in groups with more active lesions (7.6, 7.9, 8.4 and 8.3, respectively, p=0.015). Occult and minimally classic lesions were more frequent in the more active groups (p=0.024). CONCLUSIONS: Persistent activity of neovascular lesions during 12 months after starting intravitreal therapy was not associated with worse visual outcomes in this observational study of AMD. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
AIM: To describe outcomes of eyes with wet age-related macular degeneration (AMD) subdivided by lesion activity in a large multicentre cohort study. METHODS: Treatment-naive eyes with subfoveal choroidal neovascularisation receiving antivascular endothelial growth factor therapy enrolled in the Fight Retinal Blindness observational study were included. Lesions were graded at each visit as active if there was intraretinal or subretinal fluid attributable to leak from choroidal neovascularisation lesion or fresh haemorrhage. Eyes were divided into four groups; based on the proportion of visits, each eye was graded as active during the first 12 months of treatment (persistent, high, moderate and low activity). RESULTS: 655 eyes were included. Similar mean visual acuity changes compared with baseline were observed in all four groups at 12 months (+6.8, +8.3, +6.2 and +5.5 letters for the low, moderate, high and persistent groups, respectively; p<0.001 for each group). The mean number of injections given increased only modestly in groups with more active lesions (7.6, 7.9, 8.4 and 8.3, respectively, p=0.015). Occult and minimally classic lesions were more frequent in the more active groups (p=0.024). CONCLUSIONS: Persistent activity of neovascular lesions during 12 months after starting intravitreal therapy was not associated with worse visual outcomes in this observational study of AMD. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
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