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Cited by 51Retinal Diseases and TreatmentsRetinal Imaging and AnalysisRetinal and Macular Surgery

Outcomes of Eyes with Lesions Composed of >50% Blood in the Comparison of Age-Related Macular Degeneration Treatments Trials (CATT)

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Altaweel, Michael M., Daniel, Ebenezer, Martin, Daniel F., Mittra, Robert A., Grunwald, Juan E., Lai, Michael M., Melamud, Alexander, Morse, Lawrence S. +898 more·2015·Ophthalmology
DOI 10.1016/j.ophtha.2014.08.020PMC PMC4306628
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Abstract

Objective To compare baseline characteristics, treatment frequency, visual acuity (VA), and morphologic outcomes of eyes with >50% of the lesion composed of blood (B50 group) versus all other eyes (Other group) enrolled in the Comparison of Age-Related Macular Degeneration Treatments Trials (CATT).Design Prospective cohort study within a multicenter randomized clinical trial.Participants CATT patients with neovascular age-related macular degeneration (AMD).Methods Treatment for the study eye was assigned randomly to either ranibizumab or bevacizumab and to 3 different dosing regimens over a 2-year period. Reading center graders evaluated baseline and follow-up morphology in color fundus photographs, fluorescein angiography (FA), and optical coherence tomography (OCT). Masked examiners tested VA.Main outcome measures Morphologic features and VA at 1 and 2 years.Results The B50 group consisted of 84 of 1185 (7.1%) patients enrolled in CATT. Baseline lesion characteristics differed between groups. In the B50 group, choroidal neovascularization size was smaller (0.73 vs 1.83 disc areas [DA]; P < 0.001), total lesion size was greater (4.55 vs 2.31 DA; P <0.001), total retinal thickness was greater (524 vs 455 μm; P = 0.02), and mean VA was worse (56.0 vs 60.9 letters; P = 0.002). Increases in mean VA were similar in the B50 and Other groups at 1 year (+9.3 vs +7.2 letters; P = 0.22) and at 2 years (9.0 vs 6.1 letters; P = 0.17). Eyes treated PRN received a similar number of injections in the 2 groups (12.2 vs 13.4; P = 0.27). Mean lesion size in the B50 group decreased by 1.2 DA at both 1 and 2 years (primarily owing to resolution of hemorrhage) and increased in the Other group by 0.33 DA at 1 year and 0.91 DA at 2 years (P < 0.001). Leakage on FA and fluid on OCT were similar between groups at 1 and 2 years.Conclusions In CATT, the B50 group had a visual prognosis similar to the Other group. Lesion size decreased markedly through 2 years. Eyes like those enrolled in CATT with neovascular AMD lesions composed of >50% blood can be managed similarly to those with less or no blood.

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Altaweel, M. M., Daniel, E., Martin, D. F., Mittra, R. A., Grunwald, J. E., Lai, M. M., Melamud, A., Morse, L. S., Huang, J., Ferris, F. L., Fine, S. L., Maguire, M. G., Williams, D. F., 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, G. E., Aguado, H. A., 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, S. L., Anderson, N., Arnold, A., Blais, P., Googe, J., Higdon, T. 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Affiliations
  • University of Wisconsin–Madison (US)
  • ViteroRetinal Surgery (US)
  • University of California Davis Medical Center (US)
  • Cleveland Clinic (US)
  • University of Pennsylvania (US)
  • University of Colorado Denver (US)
  • National Cancer Institute (US)
Corresponding author
Altaweel, Michael M.
ORCID
Venue
Ophthalmology
Publisher
Elsevier BV
Published
2015-02
Volume
122
Issue
2
Pages
391-398.e5
ISSN
0161-6420 (ISSN-L)
DOI
10.1016/j.ophtha.2014.08.020
PMC
PMC4306628
OpenAlex
W2120355996
Cited by
51
References
46
Citations by year
2025: 3 · 2024: 4 · 2022: 3 · 2021: 5 · 2020: 8 · 2019: 6 · 2018: 6 · 2017: 5 · 2016: 5 · 2015: 5 · 2014: 1
FWCI
5.00
Type
journal article
Language
en
Open access
Licence
Locations
  • Ophthalmology (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health
  • National Eye Institute
  • U.S. Department of Health and Human Services
Topics
  • Health Sciences › Medicine › Ophthalmology › Retinal Diseases and Treatments
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Retinal Imaging and Analysis
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Retinal and Macular Surgery
Keywords
neovascular age-related macular degeneration, choroidal neovascularization, ranibizumab, bevacizumab, anti-VEGF therapy, treatment frequency, visual acuity outcomes, lesion size, retinal thickness, hemorrhage resolution, dosing regimen, pro re nata dosing, intravitreal injection
MeSH terms
Bevacizumab, Ranibizumab, Aged, Aged, 80 and over, Female, Fluorescein Angiography, Follow-Up Studies, Humans, Male, Prospective Studies, Retinal Hemorrhage, Visual Acuity, Cohort Studies, Treatment Outcome, Choroidal Neovascularization, Angiogenesis Inhibitors, Tomography, Optical Coherence, Vascular Endothelial Growth Factor A, Wet Macular Degeneration, Intravitreal Injections, Antibodies, Monoclonal, Humanized

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