Improved structure and function in early detected second eye neovascular age-related macular degeneration; FASBAT/EDNA report 1

Richard P Gale, Archana Airody, Sobha Sivaprasad, Rachel L W Hanson, Victoria Allgar, Martin McKibbin, Antony B Morland, Tunde Peto, Mia Porteous, Usha Chakravarthy, FASBAT Study Group

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose
Visual acuity (VA) and structural biomarker assessment before and 24-months after early detection and routine treatment of second-eye involvement with neovascular age-related macular degeneration (nAMD) and additional comparison with the first eye affected.
Design
Prospective, 22-center observational study of participants with unilateral nAMD in the Early Detection of Neovascular AMD (EDNA) study, coenrolled into the Observing Fibrosis, Macular Atrophy and Subretinal Highly Reflective Material, Before and After Intervention with anti-VEGF Treatment (FASBAT) study for an additional 2-year follow-up.
Participants
Older adults (> 50 years) with new onset nAMD in the first eye.
Methods
Assessment of both eyes with OCT, color fundus photography (CFP), clinic-measured VA, and quality of life (QoL).
Main Outcome Measures
Prevalence of atrophy, subretinal hyperreflective material (SHRM), intraretinal fluid (IRF), subretinal fluid (SRF), and changes in VA over the study duration in both the first and second eyes affected with nAMD. Composite QoL scores over time.
Results
Of 431 participants recruited to the FASBAT study, the second eye converted to nAMD in 100 participants at a mean of 18.9 months. Visual acuity was 18 letters better at the time of early diagnosis in the second eye compared with conventional diagnosis in the first eye (72.9 vs. 55.6 letters). Visual acuity remained better in the second eye 24.9 months postconversion, at 69.5 letters compared with 59.7 letters at a similar matched time point in the first eye (18.9 months). A greater proportion of participants had vision > 70 letters in the second eye versus the first eye, 24.9 months postconversion (61 vs. 35). Prevalence of SHRM and IRF was lower in the second eye compared with the first eye 24.9 months postconversion. However, SRF prevalence was greater in the second eye 24.9 months postconversion. The development and progression of total area of atrophy appears similar in both eyes. Mean composite QoL scores increased over time, with a significant correlation between VA for the second eye only 24.9 months postconversion.
Conclusion
This study has shown that early detection of exudative AMD in the second eye is associated with reduced prevalence of SHRM and IRF and greater VA, which is significantly correlated with maintained QoL. Financial Disclosure(s): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this aertcle.
Original languageEnglish
JournalOpthalmology Retina
Early online date01 Jan 2024
DOIs
Publication statusEarly online date - 01 Jan 2024

Keywords

  • Intraretinal fluid
  • Hyperreflective material
  • Fibrosis
  • Fellow eyes
  • Early detection
  • Quality-of-life
  • Subretinal fluid
  • Neovascular age-related macular degeneration
  • Atrophy

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