Michael M Altaweel1, Ebenezer Daniel2, Daniel F Martin3, Robert A Mittra4, Juan E Grunwald2, Michael M Lai5, Alexander Melamud5, Lawrence S Morse6, Jiayan Huang2, Frederick L Ferris7, Stuart L Fine8, Maureen G Maguire2. 1. Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, Wisconsin. Electronic address: mmaltaweel@wisc.edu. 2. Department of Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania. 3. Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio. 4. VitreoRetinal Surgery, Edina, Minnesota. 5. Retina Group of Washington, Chevy Chase, Maryland. 6. Department of Ophthalmology, University of California-Davis Medical Center, Sacramento, California. 7. Epidemiology and Clinical Research, National Eye Institute, Bethesda, Maryland. 8. Department of Ophthalmology, University of Colorado-Denver, Aurora, Colorado.
Abstract
OBJECTIVE: To compare baseline characteristics, treatment frequency, visual acuity (VA), and morphologic outcomes of eyes with >50% of the lesion composed of blood (B50 group) versus all other eyes (Other group) enrolled in the Comparison of Age-Related Macular Degeneration Treatments Trials (CATT). DESIGN: Prospective cohort study within a multicenter randomized clinical trial. PARTICIPANTS: CATT patients with neovascular age-related macular degeneration (AMD). METHODS: Treatment for the study eye was assigned randomly to either ranibizumab or bevacizumab and to 3 different dosing regimens over a 2-year period. Reading center graders evaluated baseline and follow-up morphology in color fundus photographs, fluorescein angiography (FA), and optical coherence tomography (OCT). Masked examiners tested VA. MAIN OUTCOME MEASURES: Morphologic features and VA at 1 and 2 years. RESULTS: The B50 group consisted of 84 of 1185 (7.1%) patients enrolled in CATT. Baseline lesion characteristics differed between groups. In the B50 group, choroidal neovascularization size was smaller (0.73 vs 1.83 disc areas [DA]; P < 0.001), total lesion size was greater (4.55 vs 2.31 DA; P <0.001), total retinal thickness was greater (524 vs 455 μm; P = 0.02), and mean VA was worse (56.0 vs 60.9 letters; P = 0.002). Increases in mean VA were similar in the B50 and Other groups at 1 year (+9.3 vs +7.2 letters; P = 0.22) and at 2 years (9.0 vs 6.1 letters; P = 0.17). Eyes treated PRN received a similar number of injections in the 2 groups (12.2 vs 13.4; P = 0.27). Mean lesion size in the B50 group decreased by 1.2 DA at both 1 and 2 years (primarily owing to resolution of hemorrhage) and increased in the Other group by 0.33 DA at 1 year and 0.91 DA at 2 years (P < 0.001). Leakage on FA and fluid on OCT were similar between groups at 1 and 2 years. CONCLUSIONS: In CATT, the B50 group had a visual prognosis similar to the Other group. Lesion size decreased markedly through 2 years. Eyes like those enrolled in CATT with neovascular AMD lesions composed of >50% blood can be managed similarly to those with less or no blood.
RCT Entities:
OBJECTIVE: To compare baseline characteristics, treatment frequency, visual acuity (VA), and morphologic outcomes of eyes with >50% of the lesion composed of blood (B50 group) versus all other eyes (Other group) enrolled in the Comparison of Age-Related Macular Degeneration Treatments Trials (CATT). DESIGN: Prospective cohort study within a multicenter randomized clinical trial. PARTICIPANTS: CATT patients with neovascular age-related macular degeneration (AMD). METHODS: Treatment for the study eye was assigned randomly to either ranibizumab or bevacizumab and to 3 different dosing regimens over a 2-year period. Reading center graders evaluated baseline and follow-up morphology in color fundus photographs, fluorescein angiography (FA), and optical coherence tomography (OCT). Masked examiners tested VA. MAIN OUTCOME MEASURES: Morphologic features and VA at 1 and 2 years. RESULTS: The B50 group consisted of 84 of 1185 (7.1%) patients enrolled in CATT. Baseline lesion characteristics differed between groups. In the B50 group, choroidal neovascularization size was smaller (0.73 vs 1.83 disc areas [DA]; P < 0.001), total lesion size was greater (4.55 vs 2.31 DA; P <0.001), total retinal thickness was greater (524 vs 455 μm; P = 0.02), and mean VA was worse (56.0 vs 60.9 letters; P = 0.002). Increases in mean VA were similar in the B50 and Other groups at 1 year (+9.3 vs +7.2 letters; P = 0.22) and at 2 years (9.0 vs 6.1 letters; P = 0.17). Eyes treated PRN received a similar number of injections in the 2 groups (12.2 vs 13.4; P = 0.27). Mean lesion size in the B50 group decreased by 1.2 DA at both 1 and 2 years (primarily owing to resolution of hemorrhage) and increased in the Other group by 0.33 DA at 1 year and 0.91 DA at 2 years (P < 0.001). Leakage on FA and fluid on OCT were similar between groups at 1 and 2 years. CONCLUSIONS: In CATT, the B50 group had a visual prognosis similar to the Other group. Lesion size decreased markedly through 2 years. Eyes like those enrolled in CATT with neovascular AMD lesions composed of >50% blood can be managed similarly to those with less or no blood.
Authors: Clement K Chan; Prema Abraham; Carsten H Meyer; Gregg T Kokame; Peter K Kaiser; Michael E Rauser; Jeffrey G Gross; Asha S D Nuthi; Steven G Lin; Noha S Daher Journal: Retina Date: 2010-02 Impact factor: 4.256
Authors: Francis Char DeCroos; Cynthia A Toth; Sandra S Stinnett; Cynthia S Heydary; Russell Burns; Glenn J Jaffe Journal: Ophthalmology Date: 2012-08-28 Impact factor: 12.079
Authors: Margaret A Chang; Diana V Do; Susan B Bressler; Sandra D Cassard; Emily W Gower; Neil M Bressler Journal: Retina Date: 2010-09 Impact factor: 4.256
Authors: Gary Shienbaum; Carlos Alexandre A Garcia Filho; Harry W Flynn; Renata Portella Nunes; William E Smiddy; Philip J Rosenfeld Journal: Am J Ophthalmol Date: 2013-03-07 Impact factor: 5.258
Authors: Jeffrey S Heier; David M Brown; Victor Chong; Jean-Francois Korobelnik; Peter K Kaiser; Quan Dong Nguyen; Bernd Kirchhof; Allen Ho; Yuichiro Ogura; George D Yancopoulos; Neil Stahl; Robert Vitti; Alyson J Berliner; Yuhwen Soo; Majid Anderesi; Georg Groetzbach; Bernd Sommerauer; Rupert Sandbrink; Christian Simader; Ursula Schmidt-Erfurth Journal: Ophthalmology Date: 2012-10-17 Impact factor: 12.079
Authors: Ebenezer Daniel; Wei Pan; Gui-Shuang Ying; Benjamin J Kim; Juan E Grunwald; Frederick L Ferris; Glenn J Jaffe; Cynthia A Toth; Daniel F Martin; Stuart L Fine; Maureen G Maguire Journal: Ophthalmology Date: 2018-02-14 Impact factor: 12.079
Authors: Jae Hui Kim; Chul Gu Kim; Dong Won Lee; Su Jin Yoo; Young Ju Lew; Han Joo Cho; Joo Yeon Kim; Seok Hyun Lee; Jong Woo Kim Journal: Graefes Arch Clin Exp Ophthalmol Date: 2019-11-18 Impact factor: 3.117
Authors: Gui-Shuang Ying; Maureen G Maguire; Ebenezer Daniel; Juan E Grunwald; Osama Ahmed; Daniel F Martin Journal: Ophthalmology Date: 2015-11-04 Impact factor: 12.079
Authors: Sharon D Solomon; Kristina Lindsley; Satyanarayana S Vedula; Magdalena G Krzystolik; Barbara S Hawkins Journal: Cochrane Database Syst Rev Date: 2019-03-04