Impact of ocular and systemic risk factors on progression of geographic atrophy in age-related macular degeneration

2021 ◽  
pp. 102171
Author(s):  
Nedime Sahinoglu-Keskek ◽  
Figen Sermet
Keyword(s):  
Risk Factors ◽  
Macular Degeneration ◽  
Systemic Risk ◽  
Geographic Atrophy ◽  
Age Related Macular Degeneration ◽  
Age Related ◽  
Systemic Risk Factors

Six-year incidence of age-related macular degeneration and correlation to OCT-derived drusen volume measurements in a Chinese population

2021 ◽  
pp. bjophthalmol-2021-319290
Author(s):  
Anna CS Tan ◽  
Miao Li Chee ◽  
Beau J Fenner ◽  
Paul Mitchell ◽  
Yih Chung Tham ◽  
...  
Keyword(s):  
Risk Factors ◽  
Macular Degeneration ◽  
Systemic Risk ◽  
Retinal Pigment ◽  
Older Age ◽  
Age Related Macular Degeneration ◽  
Fundus Photography ◽  
Age Related ◽  
Systemic Risk Factors ◽  
Sd Oct

AimsTo report the 6-year incidence of optical coherence tomography (OCT)-derived age-related changes in drusen volume and related systemic and ocular associations.MethodsChinese adults aged 40 years and older were assessed at baseline and 6 years with colour fundus photography (CFP) and spectral domain (SD) OCT. CFPs were graded for age-related macular degeneration (AMD) features and drusen volume was generated using commercially available automated software.ResultsA total of 4172 eyes of 2580 participants (mean age 58.12±9.03 years; 51.12% women) had baseline and 6-year follow-up CFP for grading, of these, 2130 eyes of 1305 participants had gradable SD-OCT images, available for analysis. Based on CFP grading, 136 (3.39%) participants developed incident early AMD and 10 (0.25%) late AMD. Concurrently, retinal pigment epithelial-Bruch’s membrane (RPE-BrC) volumes decreased, remained stable and increased in 6.8%, 78.5% and 14.7%, respectively, over 6 years. In eyes where RPE-BrC volumes were >0 mm3 at baseline, this was associated with two-fold higher prevalence rate of any AMD at baseline (p<0.001). Multivariable analysis showed that when compared with eyes where RPE-BrC volume was unchanged, volume decrease was significantly associated with older age (OR=1.30; p<0.001), smoking (OR=2.21; p=0.001) and chronic kidney disease (OR=3.4, p=0.008), while increase was associated with older age (OR=1.36; p<0.001) and hypertension (OR=1.43; p=0.016).ConclusionAMD incidence detected at 6 years on CFP and correlated OCT-derived drusen volume measurement change is low. Older age and some systemic risk factors are associated with drusen volume change, and our data provide new insights into relationship between systemic risk factors and outer retinal morphology in Asian eyes.

Discovery of Factors Influencing the Growth of Geographic Atrophy in Patients with Age-related Macular Degeneration

2007 ◽  
Vol 46 (04) ◽  
pp. 432-439 ◽  
Author(s):  
J. Dolar-Szczasny ◽  
A. Bindewald ◽  
F. G. Holz ◽  
U. Mansmann ◽  
J. Dreyhaupt
Keyword(s):  
Risk Factors ◽  
Macular Degeneration ◽  
Selection Procedure ◽  
Geographic Atrophy ◽  
Age Related Macular Degeneration ◽  
Forward Selection ◽  
Factors Influencing ◽  
Age Related ◽  
Post Hoc ◽  
The Given

Summary Objectives: Identifying factors influencing the growth of geographic atrophy (GA) in patients with age-related macular degeneration (AMD). Methods: Data on the natural course and suspected modifying factors were collected as part of the multicenter, longitudinal, observational FAM-study in 178 eyes of 114 patients with atrophic AMD. The endpoint of interest – the size of GA – was measured in fundus autofluorescence images. The influence of different putative riskfactors on progression of GA is investigated with a forward selection procedure based on the likelihood ratio test. In orderto interpret non-significant results of the forward selection procedure, the power of the tests usedwas quantified bya parametric post-hoc bootstrap approach. Results: A mean increase in GA of 175 mm2 per year was estimated for the given population (95% CI: [1.46; 2.02]). Patient and eye-specific random effects could be assessed. Neither patient-specific riskfactors nor ocular-specific risk factors show any significant influence on GA growth. The post-hoc bootstrap procedure shows that only very strong effects can be detected on the basis of the given data. For example, the hypercholesteremia which would result in an additional increase of GA by near 4mm2 per year can be detected with a power of 80%. Conclusions: The use of linear mixed effects regression models offers a convenient way to explore sources of variation in the natural course of GA. Data from further follow-up examinations and data about other putative riskfactors than those investigated will be needed to further investigate of the GA growth process. The procedure described in this article is easily applicable to other putative risk factors as well as to other fields of application.

scholarly journals A Review of Completed and Ongoing Complement Inhibitor Trials for Geographic Atrophy Secondary to Age-Related Macular Degeneration

2021 ◽  
Vol 10 (12) ◽  
pp. 2580
Author(s):  
Omar A. Halawa ◽  
Jonathan B. Lin ◽  
Joan W. Miller ◽  
Demetrios G. Vavvas
Keyword(s):  
Macular Degeneration ◽  
Geographic Atrophy ◽  
Age Related Macular Degeneration ◽  
Western World ◽  
Complement Factor ◽  
Complement Protein ◽  
Pivotal Phase ◽  
Complement Inhibition ◽  
Exudative Amd ◽  
Age Related

Age-related macular degeneration (AMD) is a leading cause of irreversible blindness among older adults in the Western world. While therapies exist for patients with exudative AMD, there are currently no approved therapies for non-exudative AMD and its advanced form of geographic atrophy (GA). The discovery of genetic variants in complement protein loci with increased susceptibility to AMD has led to the investigation of the role of complement inhibition in AMD with a focus on GA. Here, we review completed and ongoing clinical trials evaluating the safety and efficacy of these studies. Overall, complement inhibition in GA has yielded mixed results. The inhibition of complement factor D has failed pivotal phase 3 trials. Studies of C3 and C5 inhibition meeting their primary endpoint are limited by high rates of discontinuation and withdrawal in the treatment arm and higher risks of conversion to exudative AMD. Studies evaluating other complement members (CFB, CFH, CFI and inhibitors of membrane attack complex—CD59) are ongoing and could offer other viable strategies.

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