GEOGRAPHIC ATROPHY IN PATIENTS RECEIVING ANTI-VASCULAR ENDOTHELIAL GROWTH FACTOR FOR NEOVASCULAR AGE-RELATED MACULAR DEGENERATION. Issue 2 (February 2015)

• Record Type: Journal Article
• Authors: Xu, Luna; Mrejen, Sarah; Jung, Jesse J.; Gallego-Pinazo, Roberto; Thompson, Desmond; Marsiglia, Marcela; Freund, K. Bailey
• Is Part Of: Retina. Volume 35:Issue 2(2015:Feb.)
• Publication Date: 2015-02
• Subjects: age-related macular degeneration -- anti-VEGF -- choroidal neovascularization -- classification of choroidal neovascularization -- geographic atrophy -- infrared imaging -- spectral domain optical coherence tomography -- treat-and-extend regimen; Retina -- Diseases -- Periodicals; Retinal Diseases; Vitreous Body; 617.735
• DOI: 10.1097/IAE.0000000000000374
• Languages: English
• ISSNs: 0275-004X

Abstract

Abstract : Purpose: To examine factors associated with the apparent growth of geographic atrophy (GA) in a consecutive series of eyes with treatment-naive neovascular age-related macular degeneration receiving intravitreal anti-vascular endothelial growth factor therapy on a treat-and-extend regimen. Methods: This was a retrospective cohort study. Two independent graders identified areas of GA using near-infrared reflectance imaging and spectral domain optical coherence tomography (SD-OCT). Neovascular lesion subtypes were classified based on fluorescein angiography (FA) as occult choroidal neovascularization, classic choroidal neovascularization, retinal angiomatous proliferation, or mixed choroidal neovascularization, and by the anatomical classification system which utilizes FA and SD-OCT as Types 1 (sub-retinal pigment epithelium), 2 (subretinal), 3 (intraretinal), or mixed neovascularization. Results: Ninety-one patients (94 eyes) fit the inclusion criteria, of which 52 eyes (55.3%) experienced apparent GA growth. The odds of developing apparent GA were significantly lower in Type 1 neovascularization compared to the other lesion types ( P < 0.001). Using both FA and SD-OCT to classify neovascular age-related macular degeneration significantly improves the goodness of fit in the correlation between apparent GA growth and baseline neovascular lesion type ( P < 0.001). Conclusion: Treatment-naive neovascular age-related macular degeneration eyes with Type 1 neovascularization at baseline were less likely to develop GA than eyes with other types. The correlation between apparent GA growth and subtype of neovascularization is stronger when lesions are classified with an anatomic grading that utilizes both FA and SD-OCT. Abstract : In eyes receiving anti-vascular endothelial growth factor therapy for neovascular age-related macular degeneration, those having Type 1 lesions at baseline are less likely to develop geographic atrophy and/or exhibit geographic atrophy growth than eyes with Type 2, 3, or mixed lesions.