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Twelve per cent of 6142 eyes treated for neovascular age‐related macular degeneration (nAMD) presented with low visual outcome within 2 years. Analysis from the Swedish Macula Registry (SMR)
Author(s) -
Schroeder Marion,
Westborg Inger,
Lövestam Adrian Monica
Publication year - 2020
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/aos.14239
Subject(s) - medicine , macular degeneration , ophthalmology , visual acuity , diabetic retinopathy , choroidal neovascularization , logistic regression , lesion , optometry , surgery , diabetes mellitus , endocrinology
Abstract Purpose To analyse characteristics from the SMR to explore the risk factors for visual acuity (VA) below ≤ 35 letters of the Early Treatment Diabetic Retinopathy Study (ETDRS) due to nAMD during a two‐year follow‐up. Methods This study evaluates 6142 treatment‐naïve eyes, with focus on a subgroup of 780 eyes with final VA outcome of ≤ 35 letters, regarding differences of baseline characteristics, change of VA, number of injections and choice of drug to predict visual outcome. Results Patients with final VA ≤ 35 letters were older; p < 0.0001, and received fewer injections, 6.2 ± 3.8 vs. 8.7 ± 5.4; p < 0.00001. Only 4% of all patients with ≥ 70 letters baseline VA decreased to a final VA of ≤ 35 letters. The two groups with a final VA of ≤ 35 letters and VA > 35 letters presented the following baseline lesion locations; p = 0.001; 61% vs. 57% subfoveal, 18% vs. 21% juxtafoveal and 4% vs. 6% extrafoveal. Lesion size, in the group with final VA ≤ 35 letters, was 2805 ± 2093 μm vs. 2440 ± 1637 μm in the group with a VA of > 35 letters; p = 0.005. A logistic regression analysis including baseline VA, best‐ or worse‐seeing eye, age, membrane size, membrane location, symptom duration showed VA; p = < 0.0001, best‐ or worse‐seeing eye; p = 0.026, age; p = < 0.0001, and membrane size; p = 0.002 to predict a decline of VA within 2 years. Conclusions In eyes treated for wet AMD and studied for 2 years, 12.7% of eyes declined to a final VA of ≤ 35 letters. Visual acuity, worse‐seeing eye treated, age and membrane size turned out as the baseline characteristics that had significantly influenced visual decline to ≤ 35 letters during the two‐year follow‐up.