학술논문
Topographic Correspondence of Macular Atrophy With Choroidal Neovascularization in Ranibizumab-treated Eyes of the TREX-AMD Trial
Document Type
Periodical
Author
Abdelfattah, Nizar Saleh; Hariri, Amir H.; Al-Sheikh, Mayss; Pitetta, Sean; Ebraheem, Adel; Wykoff, Charles C.; Sadda, SriniVas R.; Croft, Daniel E.; Brown, David M.; Wang, Rui; Payne, John F.; Clark, Lloyd; Benz, Matthew S.; Chen, Eric; Fish, Richard H.; Johnson, David L.; Kim, Rosa Y.; Major, James C., Jr.; O'Malley, Ronan E.; Schefler, Amy C.; Shah, Ankoor R.; Vance, Sushma K.; Wells, John A., III; Wong, Tien P.
Source
American Journal of Ophthalmology. August, 2018, Vol. 192, 84
Subject
Language
English
ISSN
0002-9394
Abstract
To access, purchase, authenticate, or subscribe to the full-text of this article, please visit this link: http://dx.doi.org/10.1016/j.ajo.2018.05.008 Byline: Nizar Saleh Abdelfattah [myretina@outlook.com] (a,b,*), Amir H. Hariri (a,b), Mayss Al-Sheikh (a,b), Sean Pitetta (a), Adel Ebraheem (a,b), Charles C. Wykoff (c,d), SriniVas R. Sadda (a,b), Charles C. Wykoff, Daniel E. Croft, David M. Brown, Rui Wang, John F. Payne, Lloyd Clark, Nizar Saleh Abdelfattah, SriniVas R. Sadda, Matthew S. Benz, Eric Chen, Richard H. Fish, David L. Johnson, Rosa Y. Kim, James C. Major Jr., Ronan E. O'Malley, Amy C. Schefler, Ankoor R. Shah, Sushma K. Vance, John A. Wells III, Tien P. Wong Purpose To quantify the extent of topographic correspondence between baseline (BSL) choroidal neovascularization (CNV) and macular atrophy (MA) at follow-up in eyes with neovascular age-related macular degeneration (NVAMD). Design Post hoc analysis of randomized controlled clinical trial data. Methods Sixty treatment-naive NVAMD patients from the TREX-AMD trial were followed for 18 months. Regions of month 18 macular atrophy (MA) were graded on fundus autofluorescence (FAF) with guidance of spectral-domain optical coherence tomography (SDOCT). CNV lesions were graded manually on fluorescein angiography (FA) with lesion components including classic and occult CNV delineated. FAF and FA images were registered to quantitate area and location of overlap between CNV and MA. Outcome measures included overlap of month 18 MA to BSL CNV subtype and progression of MA from BSL to month 18. Results Twenty-six eyes had both MA at month 18 and CNV at BSL. A total of 84.6% of eyes showed evidence of MA and CNV overlap. MA appeared by month 18 in regions corresponding to BSL classic CNV in 36.4% of eyes and occult CNV in 40.9%, and in both regions in 22.7%, with more area of MA (AMA) in regions of occult than classic CNV. MA position at BSL corresponded to BSL classic CNV in 76.9% of eyes and occult CNV in 61.5%, and to both regions in 15.4%, with more AMA in regions of occult than classic CNV. Among eyes with MA and CNV at BSL but with no overlap, 50% progressed to involve regions with BS -CNV. Six eyes had no BSL MA but developed MA at month 18 within regions of BSL CNV. Conclusions In ranibizumab-treated eyes with NVAMD, more MA lesions develop within the region of baseline CNV (type 1, CNV-based MA) than outside (type 2, CNV-independent MA). Baseline-MA also tends to be located within regions of CNV in the pretreatment phase. Author Affiliation: (a) Doheny Image Reading Center, Doheny Eye Institute, Los Angeles, California, USA (b) Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA (c) Retina Consultants of Houston, Houston, Texas, USA (d) Blanton Eye Institute, Houston Methodist Hospital & Weill Cornell Medical College, Houston, Texas, USA * Inquiries to Nizar Saleh Abdelfattah, Doheny Eye Institute, 1355 San Pablo St, Suite 100, Los Angeles, CA 90033, USA Article History: Accepted 5 May 2018 (footnote) Supplemental Material available at AJO.com(http://AJO.com).