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The Moorfields AMD Database Report 2 - Fellow Eye Involvement with Neovascular Age-related Macular Degeneration

View ORCID ProfileKatrin Fasler, Gabriella Moraes, Dun Jack Fu, Siegfried K. Wagner, Eesha Gokhale, Karsten U. Kortuem, Reena Chopra, Livia Faes, Gabriella Preston, Nikolas Pontikos, Praveen J. Patel, Adnan Tufail, Aaron Y. Lee, Konstantinos Balaskas, Pearse A. Keane
doi: https://doi.org/10.1101/615252
Katrin Fasler
1NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
2Department of Ophthalmology, University Hospital Zurich, Zurich, Switzerland
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  • ORCID record for Katrin Fasler
Gabriella Moraes
1NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
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Dun Jack Fu
1NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
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Siegfried K. Wagner
1NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
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Eesha Gokhale
1NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
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Karsten U. Kortuem
1NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
3University Eye Hospital, Munich, Germany
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Reena Chopra
1NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
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Livia Faes
1NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
4Eye Clinic, Cantonal Hospital of Lucerne, Lucerne, Switzerland
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Gabriella Preston
1NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
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Nikolas Pontikos
1NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
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Praveen J. Patel
1NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
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Adnan Tufail
1NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
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Aaron Y. Lee
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Konstantinos Balaskas
1NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
6School of Biological Sciences, University of Manchester, Manchester, UK
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Pearse A. Keane
1NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
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  • For correspondence: pearse.keane1@nhs.net
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ABSTRACT

Background/Aims Neovascular age-related macular degeneration (nAMD) is frequently bilateral, and previous reports on ‘fellow eyes’’ have assumed sequential treatment after a period of treatment of the first eye only. The aim of our study was to analyse baseline characteristics and visual acuity (VA) outcomes of fellow eye involvement with nAMD, specifically differentiating between sequential and non-sequential (due to macular scarring in the first eye) anti-vascular endothelial growth factor treatment and timelines for fellow eye involvement.

Methods Retrospective, electronic medical record database study of the Moorfields AMD database of 8174 eyes/120,756 single entries with data extracted between October 21, 2008 and August 9, 2018. The dataset for analysis consisted of 1180 sequential, 413 nonsequential, and 1110 unilateral eyes.

Results Mean VA of sequentially treated fellow eyes at baseline was significantly higher (62±13), VA gain over two years lower (0.65±14), and proportion of eyes with good VA (≥20/40 or 70 letters) higher (46%) than the respective first eyes (baseline VA 54±16, VA gain at two years 5.6±15, percentage of eyes with good VA 38%). Non-sequential fellow eyes showed baseline characteristics and VA outcomes similar to first eyes. Fellow eye involvement rate was 32% at two years, and median time interval to fellow eye involvement was 71 (IQR 27-147) weeks.

Conclusion This reports shows sequentially treated nAMD fellow eyes have better baseline and final VA than non-sequentially treated eyes after 2 years of treatment. Sequentially treated eyes also had a greater proportion with good VA after 2 years of treatment.

PRECIS Depending on age, fellow eye involvement occurs in 32% of patients with neovascular AMD by two years. Fellow eyes generally maintain better vision, except in cases where late-stage disease in the first eye was untreated.

Footnotes

  • Moorfields Eye Hospital NHS Foundation Trust

  • Abbreviations

    VEGF
    - vascular endothelial growth factor
    AMD
    - age related macular degeneration
    nAMD
    - neovascular age related macular degeneration
    VA
    - visual acuity
    UK
    - United Kingdom
    EMR
    - electronic medical record
    ETDRS
    - Early Treatment Diabetic Retinopathy Study
    ICHOM
    - International Consortium for Health Outcomes Measurement
    RCTs
    - randomized controlled trials
  • Copyright 
    The copyright holder for this preprint is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity. All rights reserved. No reuse allowed without permission.
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    Posted April 26, 2019.
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    The Moorfields AMD Database Report 2 - Fellow Eye Involvement with Neovascular Age-related Macular Degeneration
    Katrin Fasler, Gabriella Moraes, Dun Jack Fu, Siegfried K. Wagner, Eesha Gokhale, Karsten U. Kortuem, Reena Chopra, Livia Faes, Gabriella Preston, Nikolas Pontikos, Praveen J. Patel, Adnan Tufail, Aaron Y. Lee, Konstantinos Balaskas, Pearse A. Keane
    bioRxiv 615252; doi: https://doi.org/10.1101/615252
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    The Moorfields AMD Database Report 2 - Fellow Eye Involvement with Neovascular Age-related Macular Degeneration
    Katrin Fasler, Gabriella Moraes, Dun Jack Fu, Siegfried K. Wagner, Eesha Gokhale, Karsten U. Kortuem, Reena Chopra, Livia Faes, Gabriella Preston, Nikolas Pontikos, Praveen J. Patel, Adnan Tufail, Aaron Y. Lee, Konstantinos Balaskas, Pearse A. Keane
    bioRxiv 615252; doi: https://doi.org/10.1101/615252

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