Usha Chakravarthy1, Clare C Bailey2, Peter H Scanlon3, Martin McKibbin4, Rehna S Khan5, Sajjad Mahmood6, Louise Downey7, Narendra Dhingra8, Christopher Brand9, Christopher J Brittain10, Jeffrey R Willis10, Alessandra Venerus11, Anushini Muthutantri11, Ronald A Cantrell10. 1. Queen's University of Belfast Royal Victoria Hospital, Belfast, Ireland. Electronic address: U.Chakravarthy@qub.ac.uk. 2. University Hospitals Bristol National Health Service Foundation Trust, Bristol, United Kingdom. 3. Gloucestershire Hospitals National Health Service Foundation Trust, Cheltenham, United Kingdom. 4. Leeds Teaching Hospitals National Health Service Trust, Leeds, United Kingdom. 5. Calderdale and Huddersfield National Health Service Foundation Trust, Huddersfield, West Yorkshire, United Kingdom. 6. Central Manchester University Hospitals National Health Service Foundation Trust, Manchester, United Kingdom. 7. Hull and East Yorkshire Hospitals National Health Service Trust, Hull, United Kingdom. 8. Mid Yorkshire Hospitals National Health Service Trust, Wakefield, United Kingdom. 9. Sheffield Teaching Hospitals National Health Service Foundation Trust, Sheffield, United Kingdom. 10. Genentech, Inc., South San Francisco, California. 11. IQVIA, London, United Kingdom.
Abstract
PURPOSE: To estimate rates and risk factors for progression to geographic atrophy (GA) or choroidal neovascularization (CNV) among eyes diagnosed with early or intermediate age-related macular degeneration (AMD) in clinical practice. DESIGN: Retrospective cohort analysis of a multicenter electronic medical record (EMR) database from the United Kingdom. PARTICIPANTS: Patients aged 50 years or more with diagnosis of early/intermediate AMD in at least 1 eye (the study eye) and no evidence of CNV or GA in the study eye, from 10 clinical sites using the EMR. METHODS: Anonymized data for 40 543 patients with a diagnosis of early/intermediate AMD were extracted between October 2000 and February 2016 from EMR database records held in the 10 sites. A sample of records randomly selected from each center was used to validate disease definitions. Records were analyzed by subgroup, based on the AMD status of the fellow eye. Multivariate Cox regression models identified other predictors of disease progression. MAIN OUTCOME MEASURES: Progression rate (per 100 person-years) to GA or CNV in study eyes with early/intermediate AMD by fellow eye status and identified risk factors for progression. RESULTS: Study eyes with early/intermediate AMD and a diagnosis of CNV in the fellow eye progressed to CNV fastest (at a rate of 15.2 per 100 person-years), and those with a diagnosis of GA in the fellow eye progressed to GA fastest (11.2 per 100 person-years), compared with the rates per 100 person-years of progression to CNV (3.2-11.9) or GA (2.0-7.8) in the other subgroups. In individuals with bilateral early/intermediate AMD, rates of progression to GA or CNV were 2.0 and 3.2 per 100 person-years, respectively. In the multivariate model, age, female sex, and cardiovascular disease were associated with an increased risk for progression to advanced AMD, whereas diabetes and glaucoma were associated with a decreased rate of progression (hazard ratios, 0.45 and 0.64, respectively). CONCLUSIONS: Progression to GA or CNV was observed frequently in eyes with early/intermediate AMD, with the status of the fellow eye affecting the rate of progression. Novel associations with risk factors were observed and require replication in other cohorts.
PURPOSE: To estimate rates and risk factors for progression to geographic atrophy (GA) or choroidal neovascularization (CNV) among eyes diagnosed with early or intermediate age-related macular degeneration (AMD) in clinical practice. DESIGN: Retrospective cohort analysis of a multicenter electronic medical record (EMR) database from the United Kingdom. PARTICIPANTS: Patients aged 50 years or more with diagnosis of early/intermediate AMD in at least 1 eye (the study eye) and no evidence of CNV or GA in the study eye, from 10 clinical sites using the EMR. METHODS: Anonymized data for 40 543 patients with a diagnosis of early/intermediate AMD were extracted between October 2000 and February 2016 from EMR database records held in the 10 sites. A sample of records randomly selected from each center was used to validate disease definitions. Records were analyzed by subgroup, based on the AMD status of the fellow eye. Multivariate Cox regression models identified other predictors of disease progression. MAIN OUTCOME MEASURES: Progression rate (per 100 person-years) to GA or CNV in study eyes with early/intermediate AMD by fellow eye status and identified risk factors for progression. RESULTS: Study eyes with early/intermediate AMD and a diagnosis of CNV in the fellow eye progressed to CNV fastest (at a rate of 15.2 per 100 person-years), and those with a diagnosis of GA in the fellow eye progressed to GA fastest (11.2 per 100 person-years), compared with the rates per 100 person-years of progression to CNV (3.2-11.9) or GA (2.0-7.8) in the other subgroups. In individuals with bilateral early/intermediate AMD, rates of progression to GA or CNV were 2.0 and 3.2 per 100 person-years, respectively. In the multivariate model, age, female sex, and cardiovascular disease were associated with an increased risk for progression to advanced AMD, whereas diabetes and glaucoma were associated with a decreased rate of progression (hazard ratios, 0.45 and 0.64, respectively). CONCLUSIONS: Progression to GA or CNV was observed frequently in eyes with early/intermediate AMD, with the status of the fellow eye affecting the rate of progression. Novel associations with risk factors were observed and require replication in other cohorts.
Authors: Brandie D Wagner; Jennifer L Patnaik; Alan G Palestine; Ashley A Frazer-Abel; Rebecca Baldermann; V Michael Holers; Marc T Mathias; Naresh Mandava; Anne M Lynch Journal: Ophthalmic Epidemiol Date: 2021-04-08
Authors: Jan Henrik Terheyden; Charlotte Behning; Anna Lüning; Ludmila Wintergerst; Pier G Basile; Diana Tavares; Beatriz A Melício; Sergio Leal; George Weissgerber; Ulrich F O Luhmann; David P Crabb; Adnan Tufail; Carel Hoyng; Moritz Berger; Matthias Schmid; Rufino Silva; Cecília V Martinho; José Cunha-Vaz; Frank G Holz; Robert P Finger Journal: BMC Med Res Methodol Date: 2021-03-17 Impact factor: 4.615
Authors: Rachel C Chen; Alan G Palestine; Anne M Lynch; Jennifer L Patnaik; Brandie D Wagner; Marc T Mathias; Naresh Mandava Journal: Transl Vis Sci Technol Date: 2021-10-04 Impact factor: 3.283