Risk of geographic atrophy in the comparison of age-related macular degeneration treatments trials

To describe risk factors for geographic atrophy (GA) in the Comparison of Age-related Macular Degeneration Treatments Trials (CATT). Cohort within a randomized clinical trial. We analyzed 1024 CATT patients with no GA visible on color fundus photographs (CFPs) and/or fluorescein angiograms (FAs) at...

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Vydáno v:Ophthalmology (Rochester, Minn.) Ročník 121; číslo 1; s. 150
Hlavní autoři: Grunwald, Juan E, Daniel, Ebenezer, Huang, Jiayan, Ying, Gui-Shuang, Maguire, Maureen G, Toth, Cynthia A, Jaffe, Glenn J, Fine, Stuart L, Blodi, Barbara, Klein, Michael L, Martin, Alison A, Hagstrom, Stephanie A, Martin, Daniel F
Médium: Journal Article
Jazyk:angličtina
Vydáno: United States 01.01.2014
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ISSN:1549-4713, 1549-4713
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Abstract To describe risk factors for geographic atrophy (GA) in the Comparison of Age-related Macular Degeneration Treatments Trials (CATT). Cohort within a randomized clinical trial. We analyzed 1024 CATT patients with no GA visible on color fundus photographs (CFPs) and/or fluorescein angiograms (FAs) at enrollment. Eyes were assigned to ranibizumab (0.5 mg) or bevacizumab (1.25 mg) treatment and to a 2-year monthly or pro re nata (PRN) injection regimen, or monthly injections for 1 year and PRN for 1 year. Demographic, genetic, and baseline ocular characteristics and lesion features of CFP/FA and optical coherence tomography (OCT) were evaluated as risk factors for GA through 2 years of follow-up. Time-dependent Cox proportional hazard models were used to estimate adjusted hazard ratios (aHRs). Development of GA. By 2 years, GA developed in 187 of 1024 patients (18.3%). Baseline risk factors for GA development included baseline visual acuity (VA) ≤20/200 (aHR, 2.65; 95% confidence interval [CI], 1.43-4.93), retinal angiomatous proliferation (RAP; aHR, 1.69; 95% CI, 1.16-2.47), GA in the fellow eye (aHR, 2.07; 95% CI, 1.40-3.08), and intraretinal fluid at the foveal center (aHR, 2.10; 95% CI, 1.34-3.31). Baseline factors associated with lower risk for GA development included blocked fluorescence (aHR, 0.49; 95% CI, 0.29-0.82), OCT measurements of subretinal fluid thickness of >25 μ (aHR, 0.52; 95% CI, 0.35-0.78), subretinal tissue complex thickness of >275 compared with ≤75 μ (aHR, 0.31; 95% CI, 0.19-0.50), and vitreomacular attachment (aHR, 0.55; 95% CI, 0.31-0.97). Ranibizumab compared with bevacizumab had a higher risk (aHR, 1.43; 95% CI, 1.06-1.93), and monthly dosing had a higher risk (aHR, 1.59; 95% CI, 1.17-2.16) than PRN dosing. There were no strong associations between development of GA and the presence of risk alleles for CFH, ARMS 2, HTRA1, C3, or TLR3. Approximately one fifth of CATT patients developed GA within 2 years of treatment. Independent baseline risk factors included poor VA, RAP, foveal intraretinal fluid, monthly dosing, and treatment with ranibizumab. Anti-vascular endothelial growth factor therapy may have a role in the development of GA.
AbstractList To describe risk factors for geographic atrophy (GA) in the Comparison of Age-related Macular Degeneration Treatments Trials (CATT). Cohort within a randomized clinical trial. We analyzed 1024 CATT patients with no GA visible on color fundus photographs (CFPs) and/or fluorescein angiograms (FAs) at enrollment. Eyes were assigned to ranibizumab (0.5 mg) or bevacizumab (1.25 mg) treatment and to a 2-year monthly or pro re nata (PRN) injection regimen, or monthly injections for 1 year and PRN for 1 year. Demographic, genetic, and baseline ocular characteristics and lesion features of CFP/FA and optical coherence tomography (OCT) were evaluated as risk factors for GA through 2 years of follow-up. Time-dependent Cox proportional hazard models were used to estimate adjusted hazard ratios (aHRs). Development of GA. By 2 years, GA developed in 187 of 1024 patients (18.3%). Baseline risk factors for GA development included baseline visual acuity (VA) ≤20/200 (aHR, 2.65; 95% confidence interval [CI], 1.43-4.93), retinal angiomatous proliferation (RAP; aHR, 1.69; 95% CI, 1.16-2.47), GA in the fellow eye (aHR, 2.07; 95% CI, 1.40-3.08), and intraretinal fluid at the foveal center (aHR, 2.10; 95% CI, 1.34-3.31). Baseline factors associated with lower risk for GA development included blocked fluorescence (aHR, 0.49; 95% CI, 0.29-0.82), OCT measurements of subretinal fluid thickness of >25 μ (aHR, 0.52; 95% CI, 0.35-0.78), subretinal tissue complex thickness of >275 compared with ≤75 μ (aHR, 0.31; 95% CI, 0.19-0.50), and vitreomacular attachment (aHR, 0.55; 95% CI, 0.31-0.97). Ranibizumab compared with bevacizumab had a higher risk (aHR, 1.43; 95% CI, 1.06-1.93), and monthly dosing had a higher risk (aHR, 1.59; 95% CI, 1.17-2.16) than PRN dosing. There were no strong associations between development of GA and the presence of risk alleles for CFH, ARMS 2, HTRA1, C3, or TLR3. Approximately one fifth of CATT patients developed GA within 2 years of treatment. Independent baseline risk factors included poor VA, RAP, foveal intraretinal fluid, monthly dosing, and treatment with ranibizumab. Anti-vascular endothelial growth factor therapy may have a role in the development of GA.
To describe risk factors for geographic atrophy (GA) in the Comparison of Age-related Macular Degeneration Treatments Trials (CATT).PURPOSETo describe risk factors for geographic atrophy (GA) in the Comparison of Age-related Macular Degeneration Treatments Trials (CATT).Cohort within a randomized clinical trial.DESIGNCohort within a randomized clinical trial.We analyzed 1024 CATT patients with no GA visible on color fundus photographs (CFPs) and/or fluorescein angiograms (FAs) at enrollment.PARTICIPANTSWe analyzed 1024 CATT patients with no GA visible on color fundus photographs (CFPs) and/or fluorescein angiograms (FAs) at enrollment.Eyes were assigned to ranibizumab (0.5 mg) or bevacizumab (1.25 mg) treatment and to a 2-year monthly or pro re nata (PRN) injection regimen, or monthly injections for 1 year and PRN for 1 year. Demographic, genetic, and baseline ocular characteristics and lesion features of CFP/FA and optical coherence tomography (OCT) were evaluated as risk factors for GA through 2 years of follow-up. Time-dependent Cox proportional hazard models were used to estimate adjusted hazard ratios (aHRs).METHODSEyes were assigned to ranibizumab (0.5 mg) or bevacizumab (1.25 mg) treatment and to a 2-year monthly or pro re nata (PRN) injection regimen, or monthly injections for 1 year and PRN for 1 year. Demographic, genetic, and baseline ocular characteristics and lesion features of CFP/FA and optical coherence tomography (OCT) were evaluated as risk factors for GA through 2 years of follow-up. Time-dependent Cox proportional hazard models were used to estimate adjusted hazard ratios (aHRs).Development of GA.MAIN OUTCOME MEASURESDevelopment of GA.By 2 years, GA developed in 187 of 1024 patients (18.3%). Baseline risk factors for GA development included baseline visual acuity (VA) ≤20/200 (aHR, 2.65; 95% confidence interval [CI], 1.43-4.93), retinal angiomatous proliferation (RAP; aHR, 1.69; 95% CI, 1.16-2.47), GA in the fellow eye (aHR, 2.07; 95% CI, 1.40-3.08), and intraretinal fluid at the foveal center (aHR, 2.10; 95% CI, 1.34-3.31). Baseline factors associated with lower risk for GA development included blocked fluorescence (aHR, 0.49; 95% CI, 0.29-0.82), OCT measurements of subretinal fluid thickness of >25 μ (aHR, 0.52; 95% CI, 0.35-0.78), subretinal tissue complex thickness of >275 compared with ≤75 μ (aHR, 0.31; 95% CI, 0.19-0.50), and vitreomacular attachment (aHR, 0.55; 95% CI, 0.31-0.97). Ranibizumab compared with bevacizumab had a higher risk (aHR, 1.43; 95% CI, 1.06-1.93), and monthly dosing had a higher risk (aHR, 1.59; 95% CI, 1.17-2.16) than PRN dosing. There were no strong associations between development of GA and the presence of risk alleles for CFH, ARMS 2, HTRA1, C3, or TLR3.RESULTSBy 2 years, GA developed in 187 of 1024 patients (18.3%). Baseline risk factors for GA development included baseline visual acuity (VA) ≤20/200 (aHR, 2.65; 95% confidence interval [CI], 1.43-4.93), retinal angiomatous proliferation (RAP; aHR, 1.69; 95% CI, 1.16-2.47), GA in the fellow eye (aHR, 2.07; 95% CI, 1.40-3.08), and intraretinal fluid at the foveal center (aHR, 2.10; 95% CI, 1.34-3.31). Baseline factors associated with lower risk for GA development included blocked fluorescence (aHR, 0.49; 95% CI, 0.29-0.82), OCT measurements of subretinal fluid thickness of >25 μ (aHR, 0.52; 95% CI, 0.35-0.78), subretinal tissue complex thickness of >275 compared with ≤75 μ (aHR, 0.31; 95% CI, 0.19-0.50), and vitreomacular attachment (aHR, 0.55; 95% CI, 0.31-0.97). Ranibizumab compared with bevacizumab had a higher risk (aHR, 1.43; 95% CI, 1.06-1.93), and monthly dosing had a higher risk (aHR, 1.59; 95% CI, 1.17-2.16) than PRN dosing. There were no strong associations between development of GA and the presence of risk alleles for CFH, ARMS 2, HTRA1, C3, or TLR3.Approximately one fifth of CATT patients developed GA within 2 years of treatment. Independent baseline risk factors included poor VA, RAP, foveal intraretinal fluid, monthly dosing, and treatment with ranibizumab. Anti-vascular endothelial growth factor therapy may have a role in the development of GA.CONCLUSIONSApproximately one fifth of CATT patients developed GA within 2 years of treatment. Independent baseline risk factors included poor VA, RAP, foveal intraretinal fluid, monthly dosing, and treatment with ranibizumab. Anti-vascular endothelial growth factor therapy may have a role in the development of GA.
Author Klein, Michael L
Huang, Jiayan
Ying, Gui-Shuang
Blodi, Barbara
Daniel, Ebenezer
Fine, Stuart L
Grunwald, Juan E
Toth, Cynthia A
Martin, Alison A
Hagstrom, Stephanie A
Maguire, Maureen G
Martin, Daniel F
Jaffe, Glenn J
Author_xml – sequence: 1
  givenname: Juan E
  surname: Grunwald
  fullname: Grunwald, Juan E
  email: juangrun@mail.med.upenn.edu
  organization: Department of Ophthalmology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania. Electronic address: juangrun@mail.med.upenn.edu
– sequence: 2
  givenname: Ebenezer
  surname: Daniel
  fullname: Daniel, Ebenezer
  organization: Department of Ophthalmology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
– sequence: 3
  givenname: Jiayan
  surname: Huang
  fullname: Huang, Jiayan
  organization: Department of Ophthalmology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
– sequence: 4
  givenname: Gui-Shuang
  surname: Ying
  fullname: Ying, Gui-Shuang
  organization: Department of Ophthalmology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
– sequence: 5
  givenname: Maureen G
  surname: Maguire
  fullname: Maguire, Maureen G
  organization: Department of Ophthalmology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
– sequence: 6
  givenname: Cynthia A
  surname: Toth
  fullname: Toth, Cynthia A
  organization: Department of Ophthalmology, Duke University, Durham, North Carolina; Department of Biomedical Engineering, Duke University, Durham, North Carolina
– sequence: 7
  givenname: Glenn J
  surname: Jaffe
  fullname: Jaffe, Glenn J
  organization: Department of Ophthalmology, Duke University, Durham, North Carolina; Duke Reading Center, Duke University Eye Center, Durham, North Carolina
– sequence: 8
  givenname: Stuart L
  surname: Fine
  fullname: Fine, Stuart L
  organization: Department of Ophthalmology, University of Colorado-Denver, Aurora, Colorado
– sequence: 9
  givenname: Barbara
  surname: Blodi
  fullname: Blodi, Barbara
  organization: Department of Ophthalmology, University of Wisconsin, Madison, Wisconsin
– sequence: 10
  givenname: Michael L
  surname: Klein
  fullname: Klein, Michael L
  organization: Casey Eye Institute, Oregon Health Sciences University, Portland, Oregon
– sequence: 11
  givenname: Alison A
  surname: Martin
  fullname: Martin, Alison A
  organization: Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio
– sequence: 12
  givenname: Stephanie A
  surname: Hagstrom
  fullname: Hagstrom, Stephanie A
  organization: Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio
– sequence: 13
  givenname: Daniel F
  surname: Martin
  fullname: Martin, Daniel F
  organization: Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio
BackLink https://www.ncbi.nlm.nih.gov/pubmed/24084496$$D View this record in MEDLINE/PubMed
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References 24613824 - Ophthalmology. 2014 Jul;121(7):e35
24613823 - Ophthalmology. 2014 Jul;121(7):e34
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Snippet To describe risk factors for geographic atrophy (GA) in the Comparison of Age-related Macular Degeneration Treatments Trials (CATT). Cohort within a randomized...
To describe risk factors for geographic atrophy (GA) in the Comparison of Age-related Macular Degeneration Treatments Trials (CATT).PURPOSETo describe risk...
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StartPage 150
SubjectTerms Aged
Aged, 80 and over
Angiogenesis Inhibitors - therapeutic use
Antibodies, Monoclonal, Humanized - therapeutic use
Bevacizumab
Cohort Studies
Female
Fluorescein Angiography
Follow-Up Studies
Genotyping Techniques
Geographic Atrophy - diagnosis
Geographic Atrophy - drug therapy
Geographic Atrophy - epidemiology
Humans
Incidence
Male
Middle Aged
Proportional Hazards Models
Ranibizumab
Risk Factors
Vascular Endothelial Growth Factor A - antagonists & inhibitors
Visual Acuity - physiology
Wet Macular Degeneration - diagnosis
Wet Macular Degeneration - drug therapy
Wet Macular Degeneration - epidemiology
Title Risk of geographic atrophy in the comparison of age-related macular degeneration treatments trials
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