Macular Morphology and Visual Acuity in Year Five of the Comparison of Age-related Macular Degeneration Treatments Trials.
Macular Morphology and Visual Acuity in Year Five of the Comparison of Age-related Macular Degeneration Treatments Trials.
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DOI：
10.1016/j.ophtha.2018.08.035
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发表时间：
2019-03
期刊：
影响因子：
13.7
通讯作者：
Comparison of Age-related Macular Degeneration Treatments Trials Research Group
中科院分区：
文献类型：
--
作者：
Jaffe GJ;Ying GS;Toth CA;Daniel E;Grunwald JE;Martin DF;Maguire MG;Comparison of Age-related Macular Degeneration Treatments Trials Research Group
在老年性黄斑变性(AMD)治疗试验(CAT)的比较中，评估形态学特征与5年视力(VA)的关系。随机临床试验中的队列研究。CATT中的参与者。AMD相关脉络膜新生血管(CNV)和视力在20/25至20/320之间的眼符合条件。治疗被随机分配给雷尼比单抗或贝伐单抗，并接受3种剂量方案，为期2年，此后由眼科医生酌情决定。Va；光学相干断层扫描的厚度和形态特征；眼底摄影和荧光素血管造影的病变大小和中心凹成分。在914名(57%)活着的5岁参与者中，有523人(57%)可以使用VA和图像分级。在5年内，60%的眼有视网膜内液体(IRF)，38%有视网膜下液体(SRF)，36%有视网膜下色素上皮(RPE)液体，66%有视网膜下高反射物质(SHRM)。平均中心凹厚度(μm)视网膜为14 8(99)，SRF为5(2 1)，视网膜下组织为12 5(10 7)，SHRM为11(33)，RPE+RPE为10 3(95)。SHRM、较薄的视网膜、较大的CNV病变面积和中心凹病变(均为P<；0.001)和IRF(P<；0.05)独立地与较差的VA相关。调整后中心凹中心无病理改变的平均VA字母为62，CNV、液体或出血的平均VA字母为61，非地理性萎缩(GA)为65，非纤维性瘢痕为，GA为53，纤维性瘢痕为56。黄斑中心凹、黄斑瘢痕、黄斑中心凹CNV、SHRM、黄斑中心凹IRF、视网膜变薄、CNV病变区和GA区8个病理特征的发生或恶化在第二年到第五年与较大的VA丢失和从基线到第五年的VA丢失独立相关。在第一年到第五年，VA与先前发现的形态特征的相关性保持或加强。新的黄斑瘢痕、CNV、视网膜内液、SHRM与视网膜变薄，黄斑中心凹GA的发展或恶化，以及病变面积的增加，是从第2年到第5年VA下降的重要因素。仍然有必要开发治疗方法来解决这些不利的病理特征。
To evaluate associations of morphologic features with 5-year visual acuity (VA) in the Comparison of Age-related Macular Degeneration (AMD) Treatments Trials (CATT). Cohort study within a randomized clinical trial. Participants in CATT. Eyes with AMD-associated choroidal neovascularization (CNV) and VA between 20/25 and 20/320 were eligible. Treatment was assigned randomly to ranibizumab or bevacizumab and to 3 dosing regimens for 2 years and was at the ophthalmologists’ discretion thereafter. VA; thickness and morphological features on optical coherence tomography; lesion size and foveal composition on fundus photography and fluorescein angiography. VA and image gradings were available for 523 of 914 (57%) participants alive at 5 years. At 5 years, 60% of eyes had intraretinal fluid (IRF), 38% had subretinal fluid (SRF), 36% had sub-retinal pigment epithelium (RPE) fluid, and 66% had subretinal hyper-reflective material (SHRM). Mean (SD) foveal center thickness (μm) was 148 (99) for retina, 5 (21) for SRF, 125 (107) for subretinal tissue complex, 11 (33) for SHRM, and 103 (95) for RPE+RPE elevation. SHRM, thinner retina, greater CNV lesion area and foveal center pathology (all p<0.001) and IRF (p<0.05), were independently associated with worse VA. Adjusted mean VA letters was 62 for no pathology in the foveal center, 61 for CNV, fluid, or hemorrhage, 65 for non-geographic atrophy (GA), 64 for non-fibrotic scar, 53 for GA, and 56 for fibrotic scar. Incidence or worsening of eight pathological features (foveal GA, foveal scar, foveal CNV, SHRM, foveal IRF, retinal thinning, CNV lesion area, and GA area) between years 2 and 5 were independently associated with greater loss of VA from year 2 to 5, and VA loss from baseline to year 5. Associations between VA and morphologic features previously identified through year 1 were maintained or strengthened at year 5. New foveal scar, CNV, intraretinal fluid, SHRM and retinal thinning, development or worsening of foveal GA, and increased lesion size, are important contributers to the VA decline from year 2 to 5. A significant need to develop therapies to address these adverse pathological features remains.
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影响因子：
13.7
作者：
Willoughby AS;Ying GS;Toth CA;Maguire MG;Burns RE;Grunwald JE;Daniel E;Jaffe GJ;Comparison of Age-Related Macular Degeneration Treatments Trials Research Group
通讯作者：
Comparison of Age-Related Macular Degeneration Treatments Trials Research Group
影响因子：
13.7
作者：
Tufail, Adnan;Xing, Wen;Bunce, Catey
通讯作者：
Bunce, Catey
影响因子：
13.7
作者：
Rofagha, Soraya;Bhisitkul, Robert B.;Zhang, Kang
通讯作者：
Zhang, Kang
影响因子：
4.2
作者：
Bhisitkul, Robert B.;Mendes, Thais S.;Zhang, Kang
通讯作者：
Zhang, Kang
DOI：
10.1097/iae.0000000000001665
发表时间：
2018-06-01
影响因子：
3.3
作者：
Manayath, George J.;Shah, Vanee Sheth;Narendran, Venkatapathy
通讯作者：
Narendran, Venkatapathy