Original articleRisk of Geographic Atrophy in the Comparison of Age-related Macular Degeneration Treatments Trials
Section snippets
Methods
The CATT cohort and the methods used by the study have been described elsewhere.8, 9, 10, 11 Briefly, the cohort consisted of 1185 patients with AMD and untreated choroidal/retinal neovascularization (CNV) with either the CNV or its sequalae, such as intraretinal fluid, subretinal fluid, serous pigment epithelial detachment, hemorrhage, or blocked fluorescence involving the foveal center. Patients enrolled in 43 clinical centers in the United States between February 2008 and December 2009.
Statistical Methods
Risk factors assessed as the presence or absence of a particular feature (such as lesion features, OCT fluid) were included as categorical variables. We classified risk factors measured on a continuous scale (e.g., VA, CNV area, OCT thickness) into categories for easier clinical interpretation. Categories for continuous variables were based on either the normal range (as for retinal thickness), quartiles of the distribution (as for subretinal tissue complex thickness), or clinically relevant
Results
After excluding 82 subjects with GA at baseline and 79 subjects with missing or unknown GA, there were 1024 subjects at risk of developing GA in the CATT study (Fig 3). Among the 1024 subjects, 773 (75.5%) provided a blood sample for genotyping. Among the 1024 patients, 109 (10.6%) developed GA by the end of 1 year (Kaplan-Meier cumulative incidence rate, 0.11; 95% CI, 0.09–0.13), and 187 (18.3%) developed GA by the end of 2 years (Kaplan-Meier cumulative incidence rate, 0.19; 95% CI,
Discussion
Our study assessed lesions developing during 2 years of anti-VEGF therapy that have the characteristics of GA on color photography and FA. It is possible that the lesions that we describe in this article as GA developing in the area of total CNV lesion may not be histologically similar to the GA lesions that develop de novo in areas where no CNV lesion was previously present. However, the lesions are clinically indistinguishable at 2 years. The GA associated with CNV has been described
References (30)
- et al.
Characteristics of patients losing vision after 2 years of monthly dosing in the phase III ranibizumab clinical trials
Ophthalmology
(2011) - et al.
Photographic assessment of baseline fundus morphologic features in the Comparison of Age-Related Macular Degeneration Treatments Trials
Ophthalmology
(2012) - et al.
Macular morphology and visual acuity in the Comparison of Age-related Macular Degeneration Treatments Trials
Ophthalmology
(2013) - et al.
Optical coherence tomography grading reproducibility during the Comparison of Age-related Macular Degeneration Treatments Trials
Ophthalmology
(2012) - et al.
Pharmacogenetics for genes associated with age-related macular degeneration (AMD) in the Comparison of AMD Treatments Trials (CATT)
Ophthalmology
(2013) - et al.
Dietary omega-3 fatty acids, other fat intake, genetic susceptibility, and progression to incident geographic atrophy
Ophthalmology
(2013) - et al.
on behalf of the IVAN study investigators. Alternative treatments to inhibit VEGF in age-related choroidal neovascularisation: 2-year findings of the IVAN randomised controlled trial
Lancet
(2013) - et al.
Heritability and genome-wide association study to assess genetic differences between advanced age-related macular degeneration subtypes
Ophthalmology
(2012) Prevalence of age-related macular degeneration in the United States
Arch Ophthalmol
(2004)- et al.
Ranibizumab for neovascular age-related macular degeneration
N Engl J Med
(2006)
ANCHOR Study Group. Ranibizumab versus verteporfin for neovascular age-related macular degeneration
N Engl J Med
Optical coherence tomography after an intravitreal injection of bevacizumab (Avastin) for neovascular age-related macular degeneration
Ophthalmic Surg Lasers Imaging
Intravitreal bevacizumab (Avastin) for neovascular age-related macular degeneration
Ophthalmology
Ranibizumab and bevacizumab for neovascular age-related macular degeneration
N Engl J Med
Ranibizumab and bevacizumab for treatment of neovascular age-related macular degeneration: two-year results
Ophthalmology
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Financial Disclosures: The authors have no proprietary or commercial interest in any of the materials discussed in this article.
Supported by cooperative agreements U10 EY017823, U10 EY017825, U10 EY017826, and U10 EY017828 from the National Eye Institute, National Institutes of Health, Department of Health and Human Services. ClinicalTrials.gov number, NCT00593450.
∗Group members listed online in Appendix 1 (at http://aaojournal.org).
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A full listing of the CATT Research Group in available at http://aaojournal.org.