TY - JOUR
T1 - EFFECT OF RETINAL THICKNESS VARIABILITY ON VISUAL OUTCOMES AND FLUID PERSISTENCE IN NEOVASCULAR AGE-RELATED MACULAR DEGENERATION
T2 - A Post Hoc Analysis of the HAWK and HARRIER Studies
AU - Dugel, Pravin U.
AU - Jhaveri, Chirag D.
AU - Chakravarthy, Usha
AU - Wykoff, Charles C.
AU - Singh, Rishi P.
AU - Hamilton, Robin
AU - Weissgerber, Georges
AU - Mulyukov, Zufar
AU - Holz, Frank G.
N1 - Funding Information:
Financial support: Financial support was provided by Novartis Pharma AG (Basel, Switzerland). The sponsor or funding organization participated in the design of the study; management, analysis, and interpretation of the data and preparation, review, and approval of the manuscript.
Funding Information:
Financial disclosures: P. U. Dugel has consulted for Novartis. C. D. Jhaveri has received personal fees from Novartis. U. Chakravarthy has received speaker fees from Novartis and personal fees from Roche. C. C. Wykoff is a consultant and/or has received grants from Acucela, Adverum, Aerie Pharmaceuticals, Aerpio, Alcon, Aldeyra, Alimera Sciences, Allegro, Allergan, Alnylam, Apellis, Arctic Vision, Bausch + Lomb, Bayer, Bionic Vision Technologies, Chengdu Kanghong Biotechnologies (KHB), Clearside Biomedical, Corcept Therapeutics, DORC, EyePoint Pharmaceuticals, Gemini Therapeutics, Genentech, Graybug Vision, Gyroscope, IONIS Pharmaceuticals, IVERIC Bio, Kodiak Sciences, LMRI, Merck, Mylan, Neurotech Pharmaceuticals, NGM Biopharmaceuticals, Notal Vision, Novartis, ONL Therapeutics, Opthea, Outlook Therapeutics, Oxurion, Palatin, Polyphotonix, RecensMedical, Regeneron, RegenXBio, Roche, Samsung Bioepis, Santen, Senju, Taiwan Liposome Company, Takeda, Thea Open Innovation, Xbrane Biopharma, and Verana Health. R. P. Singh has received personal fees from Alcon, Bausch and Lomb, Genentech, Novartis, Regeneron, and Zeiss; and has received grants from Aerie, Apellis, and Graybug. R. Hamilton is a consultant for, and has received travel fees from, Novartis. G. Weissgerber and Z. Mulyukov are employed by Novartis Pharma AG. F. G. Holz is a consultant for and/or has received grants from Acucela, Allergan, Apellis, Bayer Healthcare, Boehringer-Ingelheim, Genentech/Roche, Geuder, Graybug Vision, Heidelberg Engineering, Kanghong, LIN Bioscience, Novartis, Oxurion, Pixium, Stealth BioTherapeutics, and Zeiss; has received speaker fees from Bayer Healthcare, Genentech/Roche, Heidelberg Engineering, and Zeiss; and has received travel fees from Novartis.
Publisher Copyright:
© 2022 Lippincott Williams and Wilkins. All rights reserved.
PY - 2022/3/1
Y1 - 2022/3/1
N2 - Purpose: To determine the association between central subfield thickness (CST) variability and visual outcomes in eyes with neovascular age-related macular degeneration treated with anti-vascular endothelial growth factor therapies. Methods: In this post hoc, treatment-agnostic analysis, patients (N = 1,752) were grouped into quartiles of increasing CST variation. The association between CST variability and best-corrected visual acuity was measured from baseline, or from the end of the loading phase, until the end of the study using a multilevel modeling for repeated-measures model. The association between CST variability and the presence of retinal fluid was also assessed. Results: Increased CST variability was associated with worse best-corrected visual acuity outcomes at the end of study, with a least-square mean difference in best-corrected visual acuity of 8.9 Early Treatment Diabetic Retinopathy Study letters between the quartiles with the lowest and highest CST variability at the final visit. Increased variability was also associated with a higher mean fraction of visits with the presence of fluid. Conclusion: More stable CST was associated with better visual outcomes at the end of treatment suggesting that CST variability may provide a more reliable prognostic marker of visual outcomes than the presence of fluid alone, with the potential to enhance the clinical care of neovascular age-related macular degeneration patients.
AB - Purpose: To determine the association between central subfield thickness (CST) variability and visual outcomes in eyes with neovascular age-related macular degeneration treated with anti-vascular endothelial growth factor therapies. Methods: In this post hoc, treatment-agnostic analysis, patients (N = 1,752) were grouped into quartiles of increasing CST variation. The association between CST variability and best-corrected visual acuity was measured from baseline, or from the end of the loading phase, until the end of the study using a multilevel modeling for repeated-measures model. The association between CST variability and the presence of retinal fluid was also assessed. Results: Increased CST variability was associated with worse best-corrected visual acuity outcomes at the end of study, with a least-square mean difference in best-corrected visual acuity of 8.9 Early Treatment Diabetic Retinopathy Study letters between the quartiles with the lowest and highest CST variability at the final visit. Increased variability was also associated with a higher mean fraction of visits with the presence of fluid. Conclusion: More stable CST was associated with better visual outcomes at the end of treatment suggesting that CST variability may provide a more reliable prognostic marker of visual outcomes than the presence of fluid alone, with the potential to enhance the clinical care of neovascular age-related macular degeneration patients.
KW - Anti-vascular endothelial growth factor therapy
KW - Central subfield thickness
KW - Neovascular age-related macular degeneration
KW - Variability
KW - Receptors, Vascular Endothelial Growth Factor/therapeutic use
KW - Prospective Studies
KW - Double-Blind Method
KW - Intravitreal Injections
KW - Tomography, Optical Coherence
KW - Humans
KW - Middle Aged
KW - Antibodies, Monoclonal, Humanized/therapeutic use
KW - Subretinal Fluid/physiology
KW - Organ Size
KW - Wet Macular Degeneration/diagnostic imaging
KW - Male
KW - Visual Acuity/physiology
KW - Choroidal Neovascularization/diagnostic imaging
KW - Recombinant Fusion Proteins/therapeutic use
KW - Angiogenesis Inhibitors/therapeutic use
KW - Female
KW - Aged
KW - Vascular Endothelial Growth Factor A/antagonists & inhibitors
KW - Retina/diagnostic imaging
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U2 - 10.1097/IAE.0000000000003349
DO - 10.1097/IAE.0000000000003349
M3 - Article
C2 - 34923515
AN - SCOPUS:85125009879
SN - 0275-004X
VL - 42
SP - 511
EP - 518
JO - Retina
JF - Retina
IS - 3
ER -