Intralesional Macular Atrophy in Anti-Vascular Endothelial Growth Factor Therapy for Age-Related Macular Degeneration in the IVAN Trial.

摘要: Purpose To report on the development and progression of macular atrophy (MA) its relationship with morphologic functional measures in study fellow eyes Inhibition vascular endothelial growth factor (VEGF) Age-related Choroidal Neovascularisation trial. Design Reading center analysis data from a randomized controlled Participants previously untreated neovascular age-related degeneration (nAMD) eye. Methods Color, fluorescein angiography (FA) OCT images acquired at baseline during 2-year follow-up were graded systematically for presence MA. Regression models constructed to explore relationships between MA lesion morphology vision (best-corrected distance near acuity, reading speed index, contrast sensitivity). Main Outcome Measures Primary outcome was intralesional (≥175 μm greatest linear dimension choroidal vessels seen FA and/or color, aided by OCT) lying within maximum footprint lesion. Results Study eye available 594 610 participants; 57 (9.6%) showed baseline. Incident occurred 24.4% final visit extralesional only 1.54%. In eyes, an established nAMD present 248 whom 42 (16.9%) 32 (12.9%) developed incident The odds lower that had ≥50% classic CNV (odds ratio [OR], 0.39; 95% confidence interval [CI], 0.19–0.80; P  = 0.010), subretinal fluid (OR, 0.41; CI, 0.25–0.76; 0.004), or pigment epithelial detachment 0.40; 0.21–0.74; 0.004). Secondary analyses progressed supported these findings, increasing if 2.43; 1.09–5.44; 0.030). No significant associations observed any other visual function measure. Conclusions Macular frequently develops receiving anti–VEGF therapy over 2 years. drug treatment frequency detected, providing some reassurance clinicians; however, longer-term effects remain unknown.