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Ophthalmology. 2013 Sep;120(9):1860-70. doi: 10.1016/j.ophtha.2013.01.073. Epub 2013 May 1.

Macular morphology and visual acuity in the comparison of age-related macular degeneration treatments trials.

Collaborators (892)

Williams DF, Beardsley S, Bennett S, Cantrill H, Chan-Tram C, Cheshier H, Damato K, Davies J, Dev S, Enloe J, Follano G, Gilbert P, Johnson J, Jones T, Mayleben L, Mittra R, Moos M, Neist R, Oestreich N, Quiram P, Ramsay R, Ryan E, Schindeldecker S, Snater J, Steele T, Selders D, Tonsfeldt J, Valardi S, Fish GE, Aguado HA, Arceneaux S, Arnwine J, Bell K, Bell T, Boleman B, Bradley P, Callanan D, Coors L, Creighton J, Crew T, Cummings K, Dock C, Duignan K, Fuller D, Gray K, Hendrix B, Hesse N, Jaramillo D, Jost B, Lash S, Lonsdale L, Mackens M, Mutz K, Potts M, Sanchez B, Snyder W, Solley W, Tarter C, Wang R, Williams P, Perkins SL, Anderson N, Arnold A, Blais P, Googe J, Higdon TT, Hunt C, Johnson M, Miller J, Morris CK, Morris C, Oelrich S, Oliver K, Seitz V, Whetstone J, Doft BH, Bedel J, Bergren R, Borthwick A, Conrad P, Fec A, Fulwylie C, Ingram W, Latham S, Lester G, Liu J, Lobes L, Lucko NM, Mechling H, Merlotti L, McBroom K, Olsen K, Puskas D, Rath P, Schmucker M, Schueckler L, Schultz C, Shultz H, Steinberg D, Vyas A, Whale K, Yeckel K, Orth DH, Arredondo LS, Brown S, Ciscato BJ, Civantos JM, Figliulo C, Hasan S, Kosinski B, Muir D, Nelson K, Packo K, Pollack JS, Rezaei K, Shelton G, Townsend-Patrick S, Walsh M, McDonald H, Ansari N, Bye A, Fu AD, Grout S, Indermill C, Johnson RN, Jumper J, Linares S, Lujan BJ, Munden A, Persons M, Rodriguez R, Rose JM, Teske B, Urias Y, Young S, Dreyer RF, Daniel H, Connaughton M, Handelman I, Hobbs S, Hoerner C, Hudson D, Kopfer M, Lee M, Lemley C, Logan J, Ma C, Mallet C, Milliron A, Peters M, Wohlsein H, Pearlman JA, Andrews M, Bartlett M, Carlson N, Cox E, Equi R, Gonzalez M, Griffin S, Hogue F, Kennedy L, Kryuchkov L, Lopez C, Lopez D, Luevano B, McKenna E, Patel A, Reed B, Secor N, Sison IR, Tsai T, Varghis N, Waller B, Wendel R, Yebra R, Roth DB, Deinzer J, Fine H, Green F, Green S, Keyser B, Leff S, Leviton A, Martir A, Mosenthine K, Muscle S, Okoren L, Parker S, Prenner J, Price N, Rogers D, Rosas L, Schlosser A, Studenko L, Tantum T, Wheatley H, Trese MT, Aaberg T, Bell T, Bezaire D, Bridges C, Bryant D, Capone A, Coleman M, Consolo C, Cook C, DuLong C, Garretson B, Grooten T, Hammersley J, Hassan T, Jessick H, Jones N, Kinsman C, Krumlauf J, Lewis S, Locke H, Margherio A, Markus D, Marsh T, Neal S, Noffke A, Oh K, Pence C, Preston L, Raphaelian P, Regan VR, Roberts P, Ruby A, Sarrafizadeh R, Scherf M, Scott S, Sneed S, Staples L, Terry B, Trese MT, Videtich J, Williams G, Zajechowski M, Joseph DP, Blinder K, Boyd L, Buckley S, Crow M, Dinatale A, Engelbrecht N, Forke B, Gabel D, Grand G, Grillion-Cerone J, Holekamp N, Kelly C, Nobel G, Pepple K, Raeber M, Rao P, Ressel T, Schremp S, Sgorlon M, Shears S, Thomas M, Timma C, Vaughn A, Walters C, Weeks R, Wehmeier J, Wright T, Berinstein DM, Ayyad A, Barazi MK, Bickhart E, Brady T, Byank L, Cronise A, Denny V, Dunn C, Flory M, Frantz R, Garfinkel RA, Gilbert W, Lai MM, Melamud A, Newgen J, Newton S, Oliver D, Osman M, Sanders R, von Fricken M, Dugel P, Arenas S, Balea G, Bartoli D, Bucci J, Cornelius JA, Dickens S, Doherty D, Dunlap H, Goldenberg D, Jamal K, Jimenez N, Kavanagh N, Kunimoto D, Martin J, Miner J, Mobley S, Park D, Quinlan E, Sipperley J, Slagle C, Smith D, Yafchak M, Yager R, Flaxel CJ, Bailey S, Francis P, Howell C, Hwang T, Ira S, Klein M, Lauer A, Liesegang T, Lundquist A, Nolte S, Nolte SK, Pickell S, Pope S, Rossi J, Schain M, Steinkamp P, Toomey MD, Vahrenwald D, West K, Hubbard B, Andelman S, Bergstrom C, Brower J, Cribbs B, Curtis L, Dobbs J, DuBois L, Gaultney J, Gibbs D, Jordan D, Leef D, Martin DF, Myles R, Olsen T, Schwent B, Srivastava S, Waldron R, Antoszyk AN, Balasubramaniam U, Brooks D, Brown J, Browning D, Clark L, Ennis S, Held S, Helms JV, Herby J, Karow A, Leotaud P, Massimino C, McClain D, McOwen M, Mindel J, Pereira C, Pierce R, Powers M, Price A, Rohrer J, Sanders J, Avery RL, Avery K, Basefsky J, Beckner L, Castellarin A, Couvillion S, Giust J, Giust M, Nasir M, Pieramici D, Rabena M, Risard S, See R, Smith J, Wan L, Bakri SJ, Abu-Yaghi N, Barkmeier A, Berg K, Burrington J, Edwards A, Goddard S, Howard S, Iezzi R, Lewison D, Link T, McCannel CA, Overend J, Pach J, Ruszczyk M, Shultz R, Stephan C, Vogen D, Bradford RH Jr, Bergman V, Burris R, Butt A, Daniels B, Dwiggins C, Fransen S, Guerrero T, Haivala D, Harris A, Icks S, Kingsley R, Redden L, Richmond R, Ross B, White K, Youngberg M, Topping TM, Bennett S, Chong S, Ciotti M, Cleary T, Corey E, Donovan D, Frederick A, Freese L, Graham M, Gud N, Howard T, Jones M, Morley M, Moses K, Stone J, Ty R, Wiegand T, Williams L, Winder B, Awh CC, Amonette M, Arrindell E, Beck D, Busbee B, Dilback A, Downs S, Guidry A, Gutow G, Hardin J, Hines S, Hutchins E, LaCivita K, Lester A, Malott L, McCain M, Miracle J, Moffat K, Palazzotta L, Robinson K, Sonkin P, Travis A, Wallace RT, Winters KJ, Wray J, Harris AE, Bunnell M, Crooks K, Fitzgerald R, Javid C, Kew C, Kill E, Kline P, Kreienkamp J, Martinez M, Moore RA, Saavedra E, Taylor L, Walsh M, Wilson L, Ciulla TA, Coyle E, Harrington T, Harris C, Hood C, Kerr I, Maturi R, Moore D, Morrow S, Savage J, Sink B, Steele T, Thukral N, Wilburn J, Walker JP, Banks J, Ciampaglia D, Dyshanowitz D, Frederick J, Ghuman A, Grodin R, Kiesel C, Knips E, McCue J, Ortiz M, Peters C, Raskauskas P, Schoeman E, Sharma A, Wing G, Youngblood R, Chandra SR, Altaweel M, Blodi B, Burke K, Dietzman KA, Gottlieb J, Knutson G, Krolnik D, Nork T, Olson S, Peterson J, Reed S, Soderling B, Somers G, Stevens T, Wealti A, Bearelly S, Branchaud B, Bryant JW, Crowell S, Fekrat S, Gammage M, Harrison C, Jones S, McClain N, McCuen B, Mruthyunjaya P, Queen J, Sarin N, Skalak C, Skelly M, Suner I, Tomany R, Welch L, Park SS, Cassidy A, Chandra K, Good I, Imson K, Kaur S, Metzler H, Morse L, Redenbo E, Salvador M, Telander D, Thomas M, Wallace C, Barr CC, Battcher A, Bottorff M, Chasteen M, Clark K, Denning D, Schoen D, Schultz A, Tempel E, Wheeler L, Whittington GK, Stone TW, Blevins T, Buck M, Cruz L, Heath W, Holcomb D, Isernhagen R, Kidd T, Kitchens J, Sears C, Slade E, Van Arsdall J, VanHoose B, Wolfe J, Wood W, Zilis J, Disney L, Liu M, Petty S, Sall S, Folk JC, Aly T, Brotherton A, Critser D, Hinz CJ, Karakas S, Kirschner V, Lester C, Montague C, Russell S, Stockman H, Taylor B, Verdick R, Walshire J, Thompson JT, Connell B, Constantine M, Davis JL Jr, Holsapple G, Hunter L, Lenane C, Mitchell R, Russel L, Sjaarda R, Brown DM, Benz M, Burns L, Carranza JG, Fish R, Goates D, Hay S, Jeffers T, Kegley E, Kubecka D, McGilvra S, Richter B, Sneed V, Stoever C, Tellez I, Wong T, Kim I, Andreoli C, Barresi L, Brett S, Callahan C, Capaccioli K, Carli W, Coppola M, Emmanuel N, Evans C, Fagan A, Grillo M, Head J, Kieser T, Lee E, Lord U, Miretsky E, Palitsch K, Petrin T, Reader L, Reznichenko S, Robertson M, Smith J, Vavvas D, Wells J, Cahill C, Clark W, Henry K, Johnson D, Miller P, Oliver L, Spivey R, Swinford T, Taylor M, Lambert M, Chase K, Fredrickson D, Khawly J, Lazarte V, Lowd D, Miller P, Willis A, Ferrone PJ, Almonte M, Arnott R, Aviles I, Carbon S, Chitjian M, DAmore K, Elliott C, Fastenberg D, Golub B, Graham K, Lavorna A, Murphy L, Palomo A, Puglisi C, Rhee D, Romero J, Rosenblatt B, Salcedo G, Schlameuss M, Shakin E, Sookhai V, Kaiser R, Affel E, Brown G, Centinaro C, Fine D, Fineman M, Formoso M, Garg S, Grande L, Herbert C, Ho A, Hsu J, Jay M, Lavetsky L, Liebenbaum E, Maguire J, Monsonego J, O'Connor L, Pierce L, Regillo C, Rosario M, Spirn M, Vander J, Walsh J, Davidorf FH, Barnett A, Chang S, Christoforidis J, Elliott J, Justice H, Letson A, McKinney K, Perry J, Salerno JA, Savage S, Shelley S, Singerman LJ, Coney J, DuBois J, DuBois K, Greanoff G, Himmelman D, Ilc M, Mcnamara E, Novak M, Pendergast S, Rath S, Smith-Brewer S, Tanner V, Weiss DE, Zegarra H, Halperin L, Aramayo P, Dhalla M, Fernandez B, Fernandez C, Lopez J, Lopez M, Mariano J, Murphy K, Sherley C, Veksler R, Rahhal F, Babikian R, Boyer D, Hami S, Kessinger J, Kurokouchi J, Mukarram S, Pachman S, Protacio E, Sierra J, Tabandeh H, Zamboni A, Elman M, Belz J, Butcher T, Cain T, Coffey T, Firestone D, Gore N, Singletary P, Sotirakos P, Starr J, Meredith TA, Barnhart CJ, Cantrell D, Esquejo-Leon R, Houghton O, Kaur H, NDure F, Glatzer R, Joffe L, Schindler R, Martin DF, Fine SL, Katz M, Maguire MG, Brightwell-Arnold M, Glaser R, Hall J, Harkins S, Huang J, Khvatov A, McWilliams K, Nolte SK, Peskin E, Pistilli M, Ryan S, Schnader A, Ying GS, Jaffe G, Afrani-Sakyi J, Balsley B, Bennett LS, Brooks A, Brower-Lingsch A, Bruce L, Burns R, Busian D, Choong J, Cloaninger L, DeCroos FC, DuBois E, El-Dairi M, Gach S, Hall K, Hawks T, Huang C, Heydary C, Ho A, Kini S, McCall M, Muhammad D, Nicholson J, Queen J, Rieves P, Shields K, Skalak C, Specker A, Stinnett S, Subramaniam S, Tenbrink P, Toth C, Towe A, Welch K, Williams N, Winter K, Young E, Grunwald JE, Alexander J, Daniel E, Flannagan E, Martin E, Parker C, Sepielli K, Shannon T, Whearry C, Redford M, Martin DF, Avery RL, Bakri SJ, Daniel E, Fine SL, Grunwald JE, Jaffe G, Kopfer MR, Maguire MG, Meredith TA, Peskin E, Redford M, Williams DF, Martin DF, Bennett LS, Daniel E, Ferris FL 3rd, Fine SL, Grunwald JE, Jaffe G, Maguire MG, Peskin E, Redford M, Toth C, Peskin E, Brightwell-Arnold M, DuPont J, Maguire MG, McWilliams K, Nolte SK, Friedman LM, Bressler SB, DeMets DL, Friedlander M, Johnson MW, Lindblad A, Losordo DW, Miller FG.

Abstract

OBJECTIVE:

To describe the effects of treatment for 1 year with ranibizumab or bevacizumab on macular morphology and the association of macular morphology with visual acuity (VA) in eyes with neovascular age-related macular degeneration (AMD).

DESIGN:

Prospective cohort study within a randomized clinical trial.

PARTICIPANTS:

Participants in the Comparison of Age-related Macular Degeneration Treatments Trials.

METHODS:

Participants were assigned randomly to treatment with ranibizumab or bevacizumab on a monthly or as-needed schedule. Optical coherence tomography (OCT), fluorescein angiography (FA), color fundus photography (FP), and VA testing were performed periodically throughout 52 weeks. Masked readers graded images. General linear models were applied to evaluate effects of time and treatment on outcomes.

MAIN OUTCOME MEASURES:

Fluid type and location and thickness by OCT, size, and lesion composition on FP, FA, and VA.

RESULTS:

Intraretinal fluid (IRF), subretinal fluid (SRF), subretinal pigment epithelium fluid, and retinal, subretinal, and subretinal tissue complex thickness decreased in all treatment groups. A higher proportion of eyes treated monthly with ranibizumab had fluid resolution at 4 weeks, and the difference persisted through 52 weeks. At 52 weeks, there was little association between the presence of fluid of any type (without regard to fluid location) and the mean VA. However, at all time points, eyes with residual IRF, especially foveal IRF, had worse mean VA (9 letters) than those without IRF. Eyes with abnormally thin (<120 μm) or thick (>212 μm) retinas had worse VA than those with normal thickness (120-212 μm). At week 52, eyes with larger neovascular lesions or with foveal scar had worse VA than eyes without these features.

CONCLUSIONS:

Anti-vascular endothelial growth factor (VEGF) therapy reduced lesion activity and improved VA in all treatment groups. At all time points, eyes with residual IRF had worse VA than those without. Eyes with abnormally thin or thick retinas, residual large lesions, and scar also had worse VA. Monthly ranibizumab dosing yielded more eyes with no fluid and an abnormally thin retina, although the long-term significance is unknown. These results have important treatment implications in eyes undergoing anti-VEGF therapy for neovascular AMD.

FINANCIAL DISCLOSURE(S):

Proprietary or commercial disclosure may be found after the references.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT00593450.

PMID:
23642377
PMCID:
PMC3737287
DOI:
10.1016/j.ophtha.2013.01.073
[Indexed for MEDLINE]
Free PMC Article
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