Long-term Retinal Morphology and Functional Associations in Treated Neovascular Age-Related Macular Degeneration: Findings from the Inhibition of VEGF in Age-Related Choroidal Neovascularisation Trial.
| Title: | Long-term Retinal Morphology and Functional Associations in Treated Neovascular Age-Related Macular Degeneration: Findings from the Inhibition of VEGF in Age-Related Choroidal Neovascularisation Trial. |
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| Authors: | Peto T; Queen's University of Belfast, Royal Victoria Hospital, Belfast, Ireland.; Evans RN; Bristol Trials Centre, Bristol Medical School, University of Bristol, Bristol, United Kingdom.; Reeves BC; Bristol Trials Centre, Bristol Medical School, University of Bristol, Bristol, United Kingdom.; Harding S; Department of Eye and Vision Science, University of Liverpool and St Paul's Eye Unit, Liverpool University Hospitals National Health Service Foundation Trust, Members of Liverpool Health Partners, Liverpool, United Kingdom.; Madhusudhan S; Department of Eye and Vision Science, University of Liverpool and St Paul's Eye Unit, Liverpool University Hospitals National Health Service Foundation Trust, Members of Liverpool Health Partners, Liverpool, United Kingdom.; Lotery A; Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom.; Downes S; University Hospitals National Health Service Trust, Oxford, United Kingdom.; Balaskas K; Moorfields Eye Hospital National Health Service Foundation Trust, London, United Kingdom.; Bailey CC; Department of Ophthalmology, University Hospitals Bristol National Health Service Foundation Trust, Bristol, United Kingdom.; Foss A; Department of Ophthalmology, Nottingham University Hospitals, Nottingham, United Kingdom.; Ghanchi F; Department of Ophthalmology, Bradford Royal Infirmary, Bradford, West Yorkshire, United Kingdom.; Yang Y; Department of Ophthalmology, New Cross Hospital, The Royal Wolverhampton National Health Service Trust, Wolverhampton, United Kingdom.; Phillips D; Bristol Trials Centre, Bristol Medical School, University of Bristol, Bristol, United Kingdom.; Rogers CA; Bristol Trials Centre, Bristol Medical School, University of Bristol, Bristol, United Kingdom.; Muldrew A; Queen's University of Belfast, Royal Victoria Hospital, Belfast, Ireland.; Hamill B; Queen's University of Belfast, Royal Victoria Hospital, Belfast, Ireland.; Chakravarthy U; Queen's University of Belfast, Royal Victoria Hospital, Belfast, Ireland. Electronic address: u.chakravarthy@qub.ac.uk. |
| Source: | Ophthalmology. Retina [Ophthalmol Retina] 2022 Aug; Vol. 6 (8), pp. 664-675. Date of Electronic Publication: 2022 Mar 18. |
| Publication Type: | Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't |
| Language: | English |
| Journal Info: | Publisher: Published by Elsevier Inc. on behalf of American Academy of Ophthalmology Country of Publication: United States NLM ID: 101695048 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2468-6530 (Electronic) Linking ISSN: 24686530 NLM ISO Abbreviation: Ophthalmol Retina Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: New York, NY : Published by Elsevier Inc. on behalf of American Academy of Ophthalmology, [2017]- |
| MeSH Terms: | Choroidal Neovascularization*/diagnosis ; Choroidal Neovascularization*/drug therapy ; Macular Degeneration*/drug therapy ; Retinal Detachment*; Angiogenesis Inhibitors/therapeutic use ; Atrophy/drug therapy ; Ranibizumab/therapeutic use ; Cohort Studies ; Humans ; Tomography, Optical Coherence ; Vascular Endothelial Growth Factor A |
| Abstract: | Purpose: To describe the frequency of long-term morphologic features and their relationships with visual function in participants who exited the Inhibition of VEGF in Age-Related Choroidal Neovascularisation (IVAN; ISRCTN92166560) trial.; Design: Multicenter cohort study up to 7 years after enrollment.; Participants: Patients enrolled in the IVAN trial, excluding participants who died or withdrew during the trial.; Methods: Multimodal fundus images, best-corrected visual acuity (BCVA), and low-luminance visual acuity (LLVA) were obtained for a subset of 199 participants who attended a research visit. Clinical sites (n = 20) also provided all visual acuity and clinical information from usual care records for 532 participants and submitted the most recent color, OCT, and other fundus images for 468 participants to a reading center.; Main Outcome Measures: Assessed the following from the most recent images: intralesional macular atrophy (ILMA) within the footprint of the neovascular lesion; hyperreflective material (HRM); intraretinal fluid (IRF); subretinal fluid (SRF); pigment epithelial detachment (PED); and disorganized retinal outer layers (DROLs). Cross-sectional relationships between morphologic features and BCVA/LLVA were estimated.; Results: Intralesional macular atrophy was present in 31.8% of the study eyes at IVAN exit (mean follow-up, 1.96 years) and 89.5% at the most recent imaging visit (mean follow-up, 6.18 years). Hyperreflective material, IRF, SRF, PED, and DROLs were present in 78.8%, 47.7%, 7.6%, 94.5%, and 55% of the study eyes, respectively. In the subset with complete imaging data, in eyes without DROL, the BCVA was worst in the thinnest outer fovea tertile (thinnest minus middle and thickest tertiles, -19.7 and -19.5 letters, respectively), whereas in eyes with DROL, the BCVA was worst in the thickest (thinnest and middle tertiles minus thickest, 12.5 and 12.2, respectively). Regression models showed that the presence of ILMA and HRM was independently associated with BCVA (22 letters worse [95% confidence interval {CI}, -11.2 to -32.8; P |
| Grant Information: | 07/36/01 United Kingdom DH_ Department of Health; 07/36/501 United Kingdom DH_ Department of Health |
| Substance Nomenclature: | 0 (Angiogenesis Inhibitors); 0 (Vascular Endothelial Growth Factor A); ZL1R02VT79 (Ranibizumab) |
| Entry Date(s): | Date Created: 20220322 Date Completed: 20220809 Latest Revision: 20250728 |
| Update Code: | 20260130 |
| DOI: | 10.1016/j.oret.2022.03.010 |
| PMID: | 35314388 |
| Database: | MEDLINE |
Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't