• Risk of Progression to Advanced AMD in a U.K. Cohort

    By Jean Shaw
    Selected By: Andrew P. Schachat, MD

    Journal Highlights

    Ophthalmology Retina, July 2020

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    Chakravarthy et al. set out to estimate the rates of progression to geographic atrophy (GA) or choroidal neovascu­larization (CNV) in eyes with early or intermediate age-related macular degeneration (AMD). They found that progression to advanced AMD occurs frequently in these eyes, particularly when GA or CNV is present in the fellow eye.

    For this retrospective cohort study, the researchers analyzed data extracted from a widely used electronic database in the United Kingdom. The data were collected between October 2000 and February 2016 at 10 retina clinics. The main outcome measure was the rate of progression to GA or CNV. A Cox proportional hazards model was used to estimate rates of progression. In addition, multivariate models were run; these included additional risk factors such as cardiovascular disease, hyper­tension, glaucoma, and smoking.

    All told, records for 40,543 patients with early/intermediate AMD were included in the analysis. The patients were divided into four subgroups: 1) those with AMD in both eyes (early: early; n = 32,655); 2) those with AMD in one eye and CNV in the fellow eye (early:CNV; n = 7,069); 3) those with AMD in one eye and GA in the fellow eye (early:GA; n = 656); and 4) those with AMD in one eye and mixed GA/CNV in the fellow eye (early:mixed; n = 163).

    Progression rates in study eyes, as expressed by 100 person-years, were as follows:

    • In the early:early group, the rates of progression to GA or CNV were 2.0 and 3.2, respectively.
    • In the early:CNV cohort, the rates of progression to GA or CNV were 4.1 and 15.2, respectively.
    • In the early:GA group, the rates of progression to GA or CNV were 11.2 and 8.5, respectively.
    • In the early:mixed cohort, the rates of progression to GA or CNV were 7.8 and 11.9, respectively.

    With regard to other risk factors, age, female sex, and cardiovascular dis­ease were associated with an increased risk of progression to advanced AMD. In contrast, diabetes and glaucoma were associated with a decreased risk of progression.

    The original article can be found here.