Visual acuity in various phenotypes of intermediate age related macular degeneration (AMD) in a multicentre cohort...

To study the associations of VA and intermediate age-related macular degeneration (iAMD) subclassifications.

This is the analysis of baseline data of a multicentre study on patients with iAMD in at least one eye. The subclassifications of iAMD were classified as: (i) iAMD with no evidence of incomplete retinal pigment epithelial and outer retinal atrophy (iRORA) or subretinal drusenoid deposits (SDD); (ii) iAMD with SDD with no iRORA; (iii) iAMD with iRORA with no SDD and (iv) iAMD with iRORA and SDD.

983 eyes from 805 patients with iAMD were analysed. The mean age was 75.8 years (SD 7.9), with 35.0% (282) male. Eyes with iRORA with SDD had lower VA relative to eyes with no iRORA and no SDD (OR = 0.98 [95% CI 0.96, 0.998]; P = 0.03). The VA in the better seeing eye was significantly higher than in the worse seeing eye. Increased age (sex adjusted OR, 1.07, 95% CI 1.05-1.09; P < 0.001) and female gender (age adjusted OR, 0.75, 95% CI 0.56-1.01; P = 0.057) were associated with SDD. Eyes with nAMD in the fellow eye had reduced odds of iRORA in the study eye (adjusted OR = 0.60, 95% CI 0.40-0.91; P = 0.015). Eyes with GA had increased odds of iRORA in the study eye (adjusted OR = 3.30, 95% CI 2.00-5.45; P < 0.001).

Baseline age, presence of SDD and/or iRORA and fellow eye status need to be considered in future clinical trials evaluating preventive or treatment options for iAMD.