Evolution of Geographic Atrophy in Participants Treated with Ranibizumab for Neovascular Age-Related Macular Degeneration

Autor: Jane S. Kim, Naima Jacobs-El, Catherine B. Meyerle, Alisa T. Thavikulwat, Jesia Hasan, Wai T. Wong, Catherine A Cukras, Henry E. Wiley, Elvira Agrón, David Valent, Emily Y. Chew
Rok vydání: 2017
Předmět:
Zdroj: Ophthalmology Retina. 1:34-41
ISSN: 2468-6530
DOI: 10.1016/j.oret.2016.09.005
Popis: Purpose To evaluate the risk factors, incidence, and rate of progression of geographic atrophy (GA) in eyes with neovascular age-related macular degeneration (nAMD) treated with ranibizumab. Design Post hoc analysis of a prospective clinical study. Participants There were 69 participants with nAMD in ≥1 eye. Methods Participants were prospectively treated in the study eye with 0.5 mg intravitreal ranibizumab. Study eyes received 4 monthly injections followed by pro re nata injections until a fluid-free macula was achieved on optical coherence tomography. Risk factors assessed included baseline demographics, treatment, and ocular characteristics on imaging. Eyes were evaluated on fundus autofluorescence for GA. The rate of GA area growth in study and fellow eyes was analyzed by linear regression of square root transformed areas. Main Outcome Measures Development of new-onset GA and rate of GA area growth measured on ocular imaging, including fundus autofluorescence images of the study eyes. Results Sixty-nine participants (mean age, 78.8±7.8 years) with an average of 40.0±13.6 months of follow-up were analyzed. Twenty-two of the 69 study eyes (32%) were treatment naive. During their first year of the study, participants received an average of 9.2±3.3 injections in the study eye. Of 63 study eyes with quality baseline images, 22 (35%) had preexisting GA. Of the remaining 41 eyes, 7 (17%) developed new-onset GA during study follow-up. Those who developed new GA were older (all ≥79 years old) and had received fewer study injections on average (6.9 vs. 10.4 injections at 1 year) compared with those who did not develop new GA. Of the 12 treatment-naive study eyes without GA at baseline, 1 (8.3%) developed new GA during the study. In 21 study eyes with quantifiable GA area, eyes with GA present at baseline (16/21) enlarged by 0.34±0.26 mm/y, compared with 0.19±0.12 mm/y in eyes developing new-onset GA (5/21). Conclusions Although 17% of study eyes without GA present at baseline receiving ranibizumab developed new GA, the role of ranibizumab in the development of GA is unclear. Further prospective longitudinal studies are required to determine the eyes most at risk of developing GA in the setting of anti–vascular endothelial growth factor treatment.
Databáze: OpenAIRE
Externí odkaz: