Macular morphology and visual acuity in the comparison of age-related macular degeneration treatments trials

To describe the effects of treatment for 1 year with ranibizumab or bevacizumab on macular morphology and the association of macular morphology with visual acuity (VA) in eyes with neovascular age-related macular degeneration (AMD). Prospective cohort study within a randomized clinical trial. Partic...

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Vydáno v:	Ophthalmology (Rochester, Minn.) Ročník 120; číslo 9; s. 1860
Hlavní autoři:	Jaffe, Glenn J, Martin, Daniel F, Toth, Cynthia A, Daniel, Ebenezer, Maguire, Maureen G, Ying, Gui-Shuang, Grunwald, Juan E, Huang, Jiayan
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	United States 01.09.2013
Témata:	Angiogenesis Inhibitors - therapeutic use Antibodies, Monoclonal, Humanized - therapeutic use Bevacizumab Fluorescein Angiography Follow-Up Studies Humans Macula Lutea - pathology Macular Degeneration - diagnosis Macular Degeneration - drug therapy Macular Degeneration - physiopathology Prospective Studies Ranibizumab Subretinal Fluid Tomography, Optical Coherence Vascular Endothelial Growth Factor A - antagonists & inhibitors Visual Acuity - physiology
ISSN:	1549-4713, 1549-4713
On-line přístup:	Zjistit podrobnosti o přístupu
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Abstract	To describe the effects of treatment for 1 year with ranibizumab or bevacizumab on macular morphology and the association of macular morphology with visual acuity (VA) in eyes with neovascular age-related macular degeneration (AMD). Prospective cohort study within a randomized clinical trial. Participants in the Comparison of Age-related Macular Degeneration Treatments Trials. Participants were assigned randomly to treatment with ranibizumab or bevacizumab on a monthly or as-needed schedule. Optical coherence tomography (OCT), fluorescein angiography (FA), color fundus photography (FP), and VA testing were performed periodically throughout 52 weeks. Masked readers graded images. General linear models were applied to evaluate effects of time and treatment on outcomes. Fluid type and location and thickness by OCT, size, and lesion composition on FP, FA, and VA. Intraretinal fluid (IRF), subretinal fluid (SRF), subretinal pigment epithelium fluid, and retinal, subretinal, and subretinal tissue complex thickness decreased in all treatment groups. A higher proportion of eyes treated monthly with ranibizumab had fluid resolution at 4 weeks, and the difference persisted through 52 weeks. At 52 weeks, there was little association between the presence of fluid of any type (without regard to fluid location) and the mean VA. However, at all time points, eyes with residual IRF, especially foveal IRF, had worse mean VA (9 letters) than those without IRF. Eyes with abnormally thin (<120 μm) or thick (>212 μm) retinas had worse VA than those with normal thickness (120-212 μm). At week 52, eyes with larger neovascular lesions or with foveal scar had worse VA than eyes without these features. Anti-vascular endothelial growth factor (VEGF) therapy reduced lesion activity and improved VA in all treatment groups. At all time points, eyes with residual IRF had worse VA than those without. Eyes with abnormally thin or thick retinas, residual large lesions, and scar also had worse VA. Monthly ranibizumab dosing yielded more eyes with no fluid and an abnormally thin retina, although the long-term significance is unknown. These results have important treatment implications in eyes undergoing anti-VEGF therapy for neovascular AMD. Proprietary or commercial disclosure may be found after the references.
AbstractList	To describe the effects of treatment for 1 year with ranibizumab or bevacizumab on macular morphology and the association of macular morphology with visual acuity (VA) in eyes with neovascular age-related macular degeneration (AMD). Prospective cohort study within a randomized clinical trial. Participants in the Comparison of Age-related Macular Degeneration Treatments Trials. Participants were assigned randomly to treatment with ranibizumab or bevacizumab on a monthly or as-needed schedule. Optical coherence tomography (OCT), fluorescein angiography (FA), color fundus photography (FP), and VA testing were performed periodically throughout 52 weeks. Masked readers graded images. General linear models were applied to evaluate effects of time and treatment on outcomes. Fluid type and location and thickness by OCT, size, and lesion composition on FP, FA, and VA. Intraretinal fluid (IRF), subretinal fluid (SRF), subretinal pigment epithelium fluid, and retinal, subretinal, and subretinal tissue complex thickness decreased in all treatment groups. A higher proportion of eyes treated monthly with ranibizumab had fluid resolution at 4 weeks, and the difference persisted through 52 weeks. At 52 weeks, there was little association between the presence of fluid of any type (without regard to fluid location) and the mean VA. However, at all time points, eyes with residual IRF, especially foveal IRF, had worse mean VA (9 letters) than those without IRF. Eyes with abnormally thin (<120 μm) or thick (>212 μm) retinas had worse VA than those with normal thickness (120-212 μm). At week 52, eyes with larger neovascular lesions or with foveal scar had worse VA than eyes without these features. Anti-vascular endothelial growth factor (VEGF) therapy reduced lesion activity and improved VA in all treatment groups. At all time points, eyes with residual IRF had worse VA than those without. Eyes with abnormally thin or thick retinas, residual large lesions, and scar also had worse VA. Monthly ranibizumab dosing yielded more eyes with no fluid and an abnormally thin retina, although the long-term significance is unknown. These results have important treatment implications in eyes undergoing anti-VEGF therapy for neovascular AMD. Proprietary or commercial disclosure may be found after the references. To describe the effects of treatment for 1 year with ranibizumab or bevacizumab on macular morphology and the association of macular morphology with visual acuity (VA) in eyes with neovascular age-related macular degeneration (AMD).OBJECTIVETo describe the effects of treatment for 1 year with ranibizumab or bevacizumab on macular morphology and the association of macular morphology with visual acuity (VA) in eyes with neovascular age-related macular degeneration (AMD).Prospective cohort study within a randomized clinical trial.DESIGNProspective cohort study within a randomized clinical trial.Participants in the Comparison of Age-related Macular Degeneration Treatments Trials.PARTICIPANTSParticipants in the Comparison of Age-related Macular Degeneration Treatments Trials.Participants were assigned randomly to treatment with ranibizumab or bevacizumab on a monthly or as-needed schedule. Optical coherence tomography (OCT), fluorescein angiography (FA), color fundus photography (FP), and VA testing were performed periodically throughout 52 weeks. Masked readers graded images. General linear models were applied to evaluate effects of time and treatment on outcomes.METHODSParticipants were assigned randomly to treatment with ranibizumab or bevacizumab on a monthly or as-needed schedule. Optical coherence tomography (OCT), fluorescein angiography (FA), color fundus photography (FP), and VA testing were performed periodically throughout 52 weeks. Masked readers graded images. General linear models were applied to evaluate effects of time and treatment on outcomes.Fluid type and location and thickness by OCT, size, and lesion composition on FP, FA, and VA.MAIN OUTCOME MEASURESFluid type and location and thickness by OCT, size, and lesion composition on FP, FA, and VA.Intraretinal fluid (IRF), subretinal fluid (SRF), subretinal pigment epithelium fluid, and retinal, subretinal, and subretinal tissue complex thickness decreased in all treatment groups. A higher proportion of eyes treated monthly with ranibizumab had fluid resolution at 4 weeks, and the difference persisted through 52 weeks. At 52 weeks, there was little association between the presence of fluid of any type (without regard to fluid location) and the mean VA. However, at all time points, eyes with residual IRF, especially foveal IRF, had worse mean VA (9 letters) than those without IRF. Eyes with abnormally thin (<120 μm) or thick (>212 μm) retinas had worse VA than those with normal thickness (120-212 μm). At week 52, eyes with larger neovascular lesions or with foveal scar had worse VA than eyes without these features.RESULTSIntraretinal fluid (IRF), subretinal fluid (SRF), subretinal pigment epithelium fluid, and retinal, subretinal, and subretinal tissue complex thickness decreased in all treatment groups. A higher proportion of eyes treated monthly with ranibizumab had fluid resolution at 4 weeks, and the difference persisted through 52 weeks. At 52 weeks, there was little association between the presence of fluid of any type (without regard to fluid location) and the mean VA. However, at all time points, eyes with residual IRF, especially foveal IRF, had worse mean VA (9 letters) than those without IRF. Eyes with abnormally thin (<120 μm) or thick (>212 μm) retinas had worse VA than those with normal thickness (120-212 μm). At week 52, eyes with larger neovascular lesions or with foveal scar had worse VA than eyes without these features.Anti-vascular endothelial growth factor (VEGF) therapy reduced lesion activity and improved VA in all treatment groups. At all time points, eyes with residual IRF had worse VA than those without. Eyes with abnormally thin or thick retinas, residual large lesions, and scar also had worse VA. Monthly ranibizumab dosing yielded more eyes with no fluid and an abnormally thin retina, although the long-term significance is unknown. These results have important treatment implications in eyes undergoing anti-VEGF therapy for neovascular AMD.CONCLUSIONSAnti-vascular endothelial growth factor (VEGF) therapy reduced lesion activity and improved VA in all treatment groups. At all time points, eyes with residual IRF had worse VA than those without. Eyes with abnormally thin or thick retinas, residual large lesions, and scar also had worse VA. Monthly ranibizumab dosing yielded more eyes with no fluid and an abnormally thin retina, although the long-term significance is unknown. These results have important treatment implications in eyes undergoing anti-VEGF therapy for neovascular AMD.Proprietary or commercial disclosure may be found after the references.FINANCIAL DISCLOSURE(S)Proprietary or commercial disclosure may be found after the references.
Author	Grunwald, Juan E Toth, Cynthia A Huang, Jiayan Maguire, Maureen G Martin, Daniel F Ying, Gui-Shuang Jaffe, Glenn J Daniel, Ebenezer
Author_xml	– sequence: 1 givenname: Glenn J surname: Jaffe fullname: Jaffe, Glenn J email: jaffe001@mc.duke.edu organization: Department of Ophthalmology, Duke University, Durham, North Carolina 27710, USA. jaffe001@mc.duke.edu – sequence: 2 givenname: Daniel F surname: Martin fullname: Martin, Daniel F – sequence: 3 givenname: Cynthia A surname: Toth fullname: Toth, Cynthia A – sequence: 4 givenname: Ebenezer surname: Daniel fullname: Daniel, Ebenezer – sequence: 5 givenname: Maureen G surname: Maguire fullname: Maguire, Maureen G – sequence: 6 givenname: Gui-Shuang surname: Ying fullname: Ying, Gui-Shuang – sequence: 7 givenname: Juan E surname: Grunwald fullname: Grunwald, Juan E – sequence: 8 givenname: Jiayan surname: Huang fullname: Huang, Jiayan
BackLink	https://www.ncbi.nlm.nih.gov/pubmed/23642377$$D View this record in MEDLINE/PubMed
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ContentType	Journal Article
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surname: Potts fullname: Potts, Michael – sequence: 55 givenname: Brenda surname: Sanchez fullname: Sanchez, Brenda – sequence: 56 givenname: William surname: Snyder fullname: Snyder, William – sequence: 57 givenname: Wayne surname: Solley fullname: Solley, Wayne – sequence: 58 givenname: Carrie surname: Tarter fullname: Tarter, Carrie – sequence: 59 givenname: Robert surname: Wang fullname: Wang, Robert – sequence: 60 givenname: Patrick surname: Williams fullname: Williams, Patrick – sequence: 61 givenname: Stephen L surname: Perkins fullname: Perkins, Stephen L – sequence: 62 givenname: Nicholas surname: Anderson fullname: Anderson, Nicholas – sequence: 63 givenname: Ann surname: Arnold fullname: Arnold, Ann – sequence: 64 givenname: Paul surname: Blais fullname: Blais, Paul – sequence: 65 givenname: Joseph surname: Googe fullname: Googe, Joseph – sequence: 66 givenname: Tina T surname: Higdon fullname: Higdon, Tina T – sequence: 67 givenname: Cecile surname: Hunt fullname: Hunt, 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givenname: Amanda surname: Fec fullname: Fec, Amanda – sequence: 82 givenname: Christina surname: Fulwylie fullname: Fulwylie, Christina – sequence: 83 givenname: Willia surname: Ingram fullname: Ingram, Willia – sequence: 84 givenname: Shawnique surname: Latham fullname: Latham, Shawnique – sequence: 85 givenname: Gina surname: Lester fullname: Lester, Gina – sequence: 86 givenname: Judy surname: Liu fullname: Liu, Judy – sequence: 87 givenname: Louis surname: Lobes fullname: Lobes, Louis – sequence: 88 givenname: Nicole M surname: Lucko fullname: Lucko, Nicole M – sequence: 89 givenname: Holly surname: Mechling fullname: Mechling, Holly – sequence: 90 givenname: Lori surname: Merlotti fullname: Merlotti, Lori – sequence: 91 givenname: Keith surname: McBroom fullname: McBroom, Keith – sequence: 92 givenname: Karl surname: Olsen fullname: Olsen, Karl – sequence: 93 givenname: Danielle surname: Puskas fullname: Puskas, Danielle – sequence: 94 givenname: Pamela surname: Rath fullname: 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Copyright	Copyright © 2013 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.
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Snippet	To describe the effects of treatment for 1 year with ranibizumab or bevacizumab on macular morphology and the association of macular morphology with visual...
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SubjectTerms	Angiogenesis Inhibitors - therapeutic use Antibodies, Monoclonal, Humanized - therapeutic use Bevacizumab Fluorescein Angiography Follow-Up Studies Humans Macula Lutea - pathology Macular Degeneration - diagnosis Macular Degeneration - drug therapy Macular Degeneration - physiopathology Prospective Studies Ranibizumab Subretinal Fluid Tomography, Optical Coherence Vascular Endothelial Growth Factor A - antagonists & inhibitors Visual Acuity - physiology
Title	Macular morphology and visual acuity in the comparison of age-related macular degeneration treatments trials
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