Relationship of Topographic Distribution of Geographic Atrophy to Visual Acuity in Nonexudative Age-Related Macular Degeneration

2020 ◽  
Author(s):  
Liangbo L. Shen ◽  
Mengyuan Sun ◽  
Aneesha Ahluwalia ◽  
Benjamin K. Young ◽  
Michael M. Park ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Degeneration ◽  
Geographic Atrophy ◽  
Age Related Macular Degeneration ◽  
Age Related ◽  
Relationship Of ◽  
Topographic Distribution

scholarly journals Percentage of Foveal versus Total Macular Geographic Atrophy as a Predictor of Visual Acuity in Age-related Macular Degeneration

2019 ◽  
Author(s):  
Saghar Bagheri ◽  
Ines Lains ◽  
Rebecca Silverman ◽  
Ivana Kim ◽  
Dean Eliott ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Degeneration ◽  
Fundus Autofluorescence ◽  
Cross Sectional Study ◽  
Geographic Atrophy ◽  
Age Related Macular Degeneration ◽  
Cross Sectional ◽  
Age Related ◽  
The Impact ◽  
Foveal Sparing

AbstractObjectivesTo investigate the relationship between visual acuity (VA), total area of geographic atrophy (GA) and percentage of foveal GA.MethodsMulticenter, retrospective cross-sectional study of patients with GA due to age-related macular degeneration. Demographics, VA, fundus autofluorescence (FAF) and optical coherence tomography (OCT) images were collected. Using FAF images aided by OCT, foveal sparing status, GA pattern, total GA size, and percentage of GA covering the foveal area - area within a 1.5 mm diameter circle centered on the fovea centralis - were assessed. Univariable and multiple linear regression analyses were performed.Results54 eyes (mean age 78.7 ±7.7 (SD), 60.0% female) were studied. Mean VA was 0.8 ± 0.6 logMAR, mean total GA 8.8 ± 6.7 mm2 and mean percentage of foveal GA was 71.5 ± 30.9%. Of all assessed eyes, 48.2% (n = 26) presented with multifocal GA, and 18.5% (n = 10) had foveal sparing. Multiple regression analysis revealed that, controlling for age and GA pattern, the percentage of foveal GA presented a statistically significant association with VA (ß = 0.41, P = 0.004). No significant associations were observed with mean total GA size, while controlling for the same variables (ß = 0.010, P = 0.440).ConclusionPercentage of foveal GA was significantly associated with VA impairment, while the same was not verified for total GA area. These findings suggest that percentage of foveal GA may represent a more useful tool for assessing the impact of GA on VA. Further validation is needed in larger cohorts.

scholarly journals Foveal-Sparing Scotomas in Advanced Dry Age-Related Macular Degeneration

2008 ◽  
Vol 102 (10) ◽  
pp. 600-610 ◽  
Author(s):  
Janet S. Sunness ◽  
Gary S. Rubin ◽  
Abraham Zuckerbrod ◽  
Carol A. Applegate
Keyword(s):  
Visual Acuity ◽  
Macular Degeneration ◽  
Geographic Atrophy ◽  
Age Related Macular Degeneration ◽  
Good Visual Acuity ◽  
Age Related ◽  
Foveal Sparing

Foveal-sparing scotomas are common in advanced dry macular degeneration (geographic atrophy). Foveal preservation may be present for a number of years. Despite good visual acuity, these patients have reduced reading rates. Magnification may not be effective if the text becomes too large to “fit” within the central spared area.

scholarly journals Low Luminance Visual Dysfunction as a Predictor of Subsequent Visual Acuity Loss from Geographic Atrophy in Age-Related Macular Degeneration

Ophthalmology ◽  
2008 ◽  
Vol 115 (9) ◽  
pp. 1480-1488.e2 ◽  
Author(s):  
Janet S. Sunness ◽  
Gary S. Rubin ◽  
Aimee Broman ◽  
Carol A. Applegate ◽  
Neil M. Bressler ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Degeneration ◽  
Geographic Atrophy ◽  
Age Related Macular Degeneration ◽  
Visual Dysfunction ◽  
Age Related ◽  
Low Luminance ◽  
Visual Acuity Loss

scholarly journals Geographic Atrophy and Foveal-Sparing Changes Related to Visual Acuity in Patients With Dry Age-Related Macular Degeneration Over Time

2017 ◽  
Vol 179 ◽  
pp. 118-128 ◽  
Author(s):  
Ramzi Gilbert Sayegh ◽  
Stefan Sacu ◽  
Roman Dunavölgyi ◽  
Maria Elisabeth Kroh ◽  
Philipp Roberts ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Degeneration ◽  
Geographic Atrophy ◽  
Age Related Macular Degeneration ◽  
Age Related ◽  
Foveal Sparing ◽  
Over Time

scholarly journals Percentage of Foveal vs Total Macular Geographic Atrophy as a Predictor of Visual Acuity in Age-Related Macular Degeneration

2019 ◽  
Vol 3 (5) ◽  
pp. 278-282 ◽  
Author(s):  
Saghar Bagheri ◽  
Ines Lains ◽  
Rebecca F. Silverman ◽  
Ivana Kim ◽  
Dean Eliott ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Degeneration ◽  
Fundus Autofluorescence ◽  
Cross Sectional Study ◽  
Geographic Atrophy ◽  
Age Related Macular Degeneration ◽  
Cross Sectional ◽  
Age Related ◽  
The Impact ◽  
Sd Oct

Purpose: This article investigates the relationship between visual acuity (VA), total area of geographic atrophy (GA), and percentage of foveal GA. Methods: A multicenter, retrospective, cross-sectional study was conducted of patients with GA due to age-related macular degeneration. Demographics, VA, fundus autofluorescence (FAF), and spectral-domain optical coherence tomography (SD-OCT) images were collected. Using FAF images aided by SD-OCT, fovea-sparing status, GA pattern, total GA size, and percentage of GA covering the foveal area—within a 1.5-mm-diameter circle centered on the fovea centralis—were assessed. Univariable and multiple linear regression analyses were performed. Results: Fifty-four eyes (mean age, 78.7 ±7.7 years [SD], 60.0% female) were studied. Mean VA was 0.8 ± 0.6 logarithm of the minimum angle of resolution (Snellen equivalent 20/126 ± 20/80), mean total GA 8.8 ± 6.7 mm2, and mean percentage of foveal GA was 71.5 ± 30.9%. Of all assessed eyes, 48.2% (n = 26) presented with multifocal GA, and 18.5% (n = 10) had foveal sparing. Multiple regression analysis revealed that, controlling for age and GA pattern, the percentage of foveal GA presented a statistically significant association with VA (ß = 0.41, P = .004). No significant associations were observed with mean total GA size, while controlling for the same variables (ß = 0.010, P = .440). Conclusions: Percentage of foveal GA was significantly associated with VA impairment, although the same was not verified for total GA area. These findings suggest that percentage of foveal GA may represent a more useful tool for assessing the impact of GA on VA. Further validation is needed in larger cohorts.

Visual acuity and progression of macular atrophy in patients receiving intravitreal anti-VEGF for age-related macular degeneration

2021 ◽  
pp. 112067212110017
Author(s):  
Marco H Ji ◽  
Natalia F Callaway ◽  
Cassie A Ludwig ◽  
Daniel Vail ◽  
Ahmad Al-Moujahed ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Degeneration ◽  
Case Series ◽  
Geographic Atrophy ◽  
Age Related Macular Degeneration ◽  
Macular Atrophy ◽  
Anti Vegf ◽  
Age Related ◽  
Case Series Study ◽  
Retinal Atrophy

Purpose: Whether intravitreal anti-vascular endothelial growth factors (VEGFs) cause retinal atrophy is still a subject of debate. We reported 13 eyes that received several injections of anti-VEGF for wet age-related macular degeneration (AMD) with good visual acuity despite geographic atrophy on imaging. Methods: This is a case series study conducted at Byers Eye Institute at Stanford University. Patients of three retina specialists with wet AMD who received six or more intravitreal injection of anti-VEGFs with visual acuity of 20/60 or better and incomplete RPE and outer retina atrophy (iRORA) or complete RPE and outer retinal atrophy (cRORA) were enrolled in this case series. Different imaging modalities were reviewed by three retina specialists comparing the baseline with the most recent exam. Results: About 13 eyes of 10 patients met the selection criteria. Eleven eyes were classified as iRORA and 2 as cRORA. Despite the development of macular atrophy on imaging after an average of 38.1 injections, eyes maintained stable visual acuity. Conclusion: The discrepancy between structural and functional findings in this cohort suggests that patients treated by anti-VEGF drugs exhibit divergent clinical outcomes for currently unknown reasons. The authors propose anti-VEGF may affect melanosomes within RPE without disrupting RPE and photoreceptors function completely. This requires further investigation.

Enlargement of atrophy and visual acuity loss in the geographic atrophy form of age-related macular degeneration

Ophthalmology ◽  
1999 ◽  
Vol 106 (9) ◽  
pp. 1768-1779 ◽  
Author(s):  
Janet S. Sunness ◽  
Joel Gonzalez-Baron ◽  
Carol A. Applegate ◽  
Neil M. Bressler ◽  
Yan Tian ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Degeneration ◽  
Geographic Atrophy ◽  
Age Related Macular Degeneration ◽  
Age Related ◽  
Visual Acuity Loss

Modeling Visual Acuity in Geographic Atrophy Secondary to Age-Related Macular Degeneration

2016 ◽  
Vol 235 (4) ◽  
pp. 215-224 ◽  
Author(s):  
Steffen Schmitz-Valckenberg ◽  
Jennifer Nadal ◽  
Rolf Fimmers ◽  
Moritz Lindner ◽  
Frank G. Holz ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Natural History ◽  
Macular Degeneration ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Lesion Size ◽  
Geographic Atrophy ◽  
Age Related Macular Degeneration ◽  
Age Related

Purpose: To analyze and model visual acuity (VA) in geographic atrophy (GA) secondary to age-related macular degeneration (AMD). Methods: The course of VA was analyzed using Turnbull's estimator in 226 eyes with uni- or bilateral GA due to AMD (151 patients; mean age 74.0 ± 7.6 years; mean follow-up time 33.4 ± 23.4 months) from the natural history FAM (Fundus-Autofluorescence Imaging in AMD) study. The variables ‘age at baseline', ‘gender', ‘lesion size', ‘diagnosis of the fellow eye', ‘status of the fovea', ‘focality of the lesion' and ‘pattern' were evaluated for effects on predicting VA using linear mixed-effects models. Results: Mean VA at baseline was 0.6 (Snellen 20/80) ± 0.4 logMAR [range -0.1 to 1.8 (20/17 to hand motions)], showing an estimated mean increase of 0.181 (95% CI 0.152-0.210) and 0.256 (0.214-0.300) after 2 and 4 years of follow-up, respectively. The percentage of eyes with a loss of ≥3 lines was 34% by 2 years and 47% by 4 years. Linear mixed model analysis suggested that 65% of VA variability could be explained by the assessed predictor variables. The strongest effect was found for the ‘status of the fovea' (0.69 logMAR units between ‘definitively spared fovea' and ‘definitive foveal involvement', p < 0.001). The second strongest effect was identified for ‘total lesion size' (effects between 0.02 and 0.09 logMAR units for each mm depending on foveal involvement, p < 0.001, square root transformed values). Conclusions: These findings underscore the importance of GA lesion characteristics as these have the strongest impact on VA. Natural history data and modeling VA to other variables will be helpful for refining outcome parameters and estimating possible benefits of therapeutic interventions.

scholarly journals Classification and Pathogenesis in Dry-Form (Non-Neovascular) Age-Related Macular Degeneration

2017 ◽  
pp. 105-111
Keyword(s):  
Visual Acuity ◽  
Macular Degeneration ◽  
Visual Loss ◽  
Geographic Atrophy ◽  
Age Related Macular Degeneration ◽  
Age Related ◽  
Visual Acuity Loss ◽  
Foveal Center ◽  
Late Stages ◽  
Membrane Level

Age-related macular degeneration is basically evaluated as non-neovascular (dry) and neovascular (wet) type. Initial stages start with atrophy, drusen development in RPE-Bruch membrane level and pigmentary changes and in final stages may result in CNVM, disciform scar, and geographic atrophic changes. Visual acuity loss is more severe and faster in neovascular ARMD, late stages of geographic atrophy involving foveal center may also cause significant visual loss.

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