Department of Ophthalmology, The University of Crete Medical School, 71110, Voutes, Greece.
Laboratory of Biostatistics, Faculty of Medicine, University of Crete, Heraklion, Greece.
Graefes Arch Clin Exp Ophthalmol. 2023 Dec;261(12):3425-3436. doi: 10.1007/s00417-023-06168-0. Epub 2023 Aug 11.
Τo evaluate the evolution of macular atrophy (MA) in patients with neovascular AMD (nAMD), compared with their fellow eyes exhibiting dry AMD (dAMD).
This retrospective study included 124 patients from three centers treated with anti-VEGF in their nAMD eye and having dAMD in the fellow eye. Patients without MA at baseline were analyzed to study the time to first MA development. Synchronous and unsynchronous time course of MA was also studied. MA was evaluated using near-infrared images, while all available optical coherence tomography (OCT) images were used to confirm the criteria proposed by the Classification of Atrophy Meetings group for complete MA.
MA first detection in nAMD eyes increased significantly from year 2 to 6 compared to dAMD eyes. Over the study's follow-up, 45.1% of nAMD-E developed MA, compared to 16.5% of fellow eyes (p < 0.001). When MA in the two eyes was compared in a synchronous paired manner over 4 years, nAMD eyes had an average MA progression rate of 0.275 mm/year versus 0.110 mm/year in their fellow dAMD eyes. Multivariate ANOVA revealed significant time (p < 0.001), eye (p = 0.003), and time-eye interaction (p < 0.001) effects. However, when MA did develop in dAMD eyes and was compared in an asynchronous manner to MA of nAMD eyes, it was found to progress faster in dAMD eyes (dAMD: 0.295 mm/year vs. nAMD: 0.176 mm/year) with a significant time-eye interaction (p = 0.015).
In this study, a significant difference in MA incidence and progression was documented in eyes with nAMD under treatment, compared to fellow eye exhibiting dAMD. Eyes with nAMD tended to develop more MA compared to fellow dAMD eyes. However, when atrophy did develop in the fellow dAMD eyes, it progressed faster over time compared to MA in nAMD eyes.
评估新生血管性年龄相关性黄斑变性（nAMD）患者的黄斑萎缩（MA）的演变，与具有干性年龄相关性黄斑变性（dAMD）的对侧眼相比。
本回顾性研究纳入了来自三个中心的 124 名接受抗血管内皮生长因子治疗的 nAMD 患者，他们的对侧眼患有 dAMD。对基线时无 MA 的患者进行分析，以研究首次 MA 发病的时间。还研究了 MA 的同步和不同步时程。使用近红外图像评估 MA，同时使用所有可用的光学相干断层扫描（OCT）图像来确认萎缩会议组提出的完全 MA 标准。
与 dAMD 眼相比，nAMD 眼的 MA 首次检测在第 2 年至第 6 年显著增加。在研究的随访期间，45.1%的 nAMD-E 发生了 MA，而其对侧眼为 16.5%（p<0.001）。当在 4 年内以同步配对的方式比较两眼的 MA 时，nAMD 眼的 MA 进展速度平均为 0.275mm/年，而其对侧 dAMD 眼为 0.110mm/年。多变量方差分析显示时间（p<0.001）、眼（p=0.003）和时间-眼交互作用（p<0.001）有显著影响。然而，当 dAMD 眼确实发生 MA 并以异步方式与 nAMD 眼的 MA 进行比较时，发现 dAMD 眼的 MA 进展更快（dAMD：0.295mm/年 vs. nAMD：0.176mm/年），且时间-眼交互作用显著（p=0.015）。
在这项研究中，与具有 dAMD 的对侧眼相比，接受治疗的 nAMD 眼的 MA 发生率和进展有显著差异。与对侧 dAMD 眼相比，nAMD 眼更容易发生 MA。然而，当对侧 dAMD 眼确实发生萎缩时，其 MA 进展速度快于 nAMD 眼。
