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Ophthalmology. 1998 Mar;105(3):441-7.

High-risk characteristics of fellow eyes of patients with unilateral neovascular age-related macular degeneration.

Author information

1
Berman-Gund Laboratory for the Study of Retinal Degenerations, Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston 02114, USA.

Abstract

OBJECTIVE:

This study aimed to determine whether clinical tests of ocular function and macular appearance independently can help to predict which patients with unilateral neovascular age-related macular degeneration (AMD) will have a choroidal neovascular membrane (CNVM) develop in their fellow eye.

DESIGN:

The study design was a prospective cohort study.

PARTICIPANTS:

One hundred twenty-seven patients with unilateral neovascular AMD observed for up to 4.5 years participated.

INTERVENTION:

Functional measurements included visual acuity, macular visual field, glare recovery time, and foveal electroretinogram amplitude and implicit time.

MAIN OUTCOME MEASURE:

The age-adjusted proportion of patients having a CNVM develop over follow-up assessed by the Cox proportional hazards model with stepwise selection was measured.

RESULTS:

On average, 8.8% of patients had a CNVM develop each year. Independent risk factors for the fellow eye were its glare recovery time in minutes (relative risk = 1.30, confidence interval = 1.10-1.54, P = 0.003) and its extent of visible macular abnormalities on a four-point scale (relative risk = 1.62, confidence interval = 1.06-2.59, P = 0.03). Of the fellow eyes that converted, the interval to have a CNVM develop was inversely related to the foveal electroretinogram implicit time.

CONCLUSIONS:

A slower recovery from glare and more extensive funduscopic changes appear to be independent risk factors for the development of a CNVM in the fellow eyes of patients with unilateral neovascular AMD. A slower foveal electroretinogram implicit time may be a sign of early stage CNVM development, perhaps because of outer retinal ischemia. These results have clinical management implications, particularly for those patients at high risk of having a potentially treatable form of AMD develop.

PMID:
9499774
DOI:
10.1016/S0161-6420(98)93025-1
[Indexed for MEDLINE]

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