Sporadic Visual Acuity Loss in the Comparison of Age-Related Macular Degeneration Treatments Trials (CATT)

被引:16
|
作者
Kim, Benjamin J. [1 ]
Ying, Gui-Shuang [1 ]
Huang, Jiayan [1 ]
Levy, Nicole E. [1 ]
Maguire, Maureen G. [1 ]
机构
[1] Univ Penn, Scheie Eye Inst, Perelman Sch Med, Philadelphia, PA 19104 USA
基金
美国国家卫生研究院;
关键词
VISION LOSS; RANIBIZUMAB; DEPRESSION; REPRODUCIBILITY; ASSOCIATION; IMPAIRMENT; PREDICTORS; OUTCOMES; OLDER;
D O I
10.1016/j.ajo.2014.04.004
中图分类号
R77 [眼科学];
学科分类号
100212 ;
摘要
PURPOSE: To evaluate transient, large visual acuity (VA) decreases, termed sporadic vision loss, during anti-vascular endothelial growth factor treatment for neovascular age-related macular degeneration (AMD). DESIGN: Cohort within a randomized clinical trial. METHODS: (SETTING) under bar : Comparison of Age-Related Macular Degeneration Treatments Trials (CATT). (STUDY POPULATION) under bar : Total of 1185 CATT patients. (MAIN OUTCOME MEASURES) under bar : Incidence of sporadic vision loss and odds ratio (OR) for association with patient and ocular factors. Sporadic vision loss was a decline of >= 15 letters from the previous visit, followed by a return at the next visit to no more than 5 letters worse than the visit before the VA loss. RESULTS: There were 143 sporadic vision loss events in 122 of 1185 patients (10.3%). Mean VA at 2 years for those with and without sporadic vision loss was 58.5 (similar to 20/63) and 68.4 (similar to 20/40) letters, respectively (P < .001). Among patients treated pro re nata, no injection was given for 27.6% (27/98) of sporadic vision loss events. Multivariate analysis demonstrated that baseline predictors for sporadic vision loss included worse baseline VA (OR 2.92, 95% confidence interval [CI]:1.65-5.17 for <= 20/200 compared with >= 20/40), scar (OR 2.21, 95% CI: 1.22-4.01), intraretinal foveal fluid on optical coherence tomography (OR 1.80, 95% CI:1.11-2.91), and medical history of anxiety (OR 1.90, 95% CI:1.12-3.24) and syncope (OR 2.75, 95% C1:1.4-55.22) Refraction decreased the likelihood of sporadic vision loss (OR 0.62, 95%CI: 0.42-0.91). CONCLUSIONS: Approximately 10% of CATT patients had sporadic vision loss. Baseline predictors included AMD-related factors and factors independent of AMD. These data are relevant for clinicians in practice and those involved in clinical trials. (C) 2014 by Elsevier Inc. All rights reserved.
引用
收藏
页码:128 / 135
页数:8
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