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Progression from Early/Intermediate to Advanced Forms of Age-Related Macular Degeneration in a Large UK Cohort: Rates
Usha Chakravarthy1, Clare C Bailey2, Peter H Scanlon3
1Queen's University of Belfast Royal Victoria Hospital, Belfast, Ireland.
Ophthalmology. Retina
|March 8, 2020
Summary
Progression to advanced age-related macular degeneration (AMD) is common in early/intermediate stages. Fellow eye status significantly impacts progression rates, with cardiovascular disease increasing risk and diabetes/glaucoma decreasing it.
Area of Science:
- Ophthalmology
- Medical Research
- Public Health
Background:
- Age-related macular degeneration (AMD) is a leading cause of vision loss.
- Early and intermediate AMD require monitoring for progression to advanced stages like geographic atrophy (GA) or choroidal neovascularization (CNV).
Purpose of the Study:
- To estimate the rates and identify risk factors for progression to GA or CNV in eyes with early or intermediate AMD.
- To analyze progression based on the clinical status of the fellow eye.
Main Methods:
- Retrospective cohort analysis of a UK multicenter electronic medical record (EMR) database.
- Inclusion of 40,543 patients aged 50+ with early/intermediate AMD and no advanced AMD in the study eye.
- Multivariate Cox regression models to identify progression predictors.
Main Results:
- Eyes with CNV or GA in the fellow eye showed the fastest progression rates to these advanced AMD forms.
- Individuals with bilateral early/intermediate AMD had progression rates of 2.0 (GA) and 3.2 (CNV) per 100 person-years.
- Age, female sex, and cardiovascular disease increased progression risk; diabetes and glaucoma decreased it.
Conclusions:
- Progression to GA or CNV is frequent in early/intermediate AMD, influenced by fellow eye status.
- Novel risk factor associations were identified, warranting further investigation and replication.
