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Sadeghi E, Vupparaboina SC, Bollepalli SC, Vupparaboina KK, Agarwal K, Sahel JA, Eller AW, Chhablani J. Incidence and risk factors of fellow-eyes wet conversion in unilateral neovascular age-related macular degeneration over 15-year follow-up. Graefes Arch Clin Exp Ophthalmol 2024:10.1007/s00417-024-06605-8. [PMID: 39174817 DOI: 10.1007/s00417-024-06605-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Revised: 07/06/2024] [Accepted: 07/31/2024] [Indexed: 08/24/2024] Open
Abstract
PURPOSE Incidence and risk factors of fellow eye wet conversion in unilateral neovascular age-related macular degeneration (nAMD) over 15-years follow-up. METHODS This retrospective study reviewed 593 unilateral nAMD patients with a minimum of five years up to 15 years of follow-up. The demographic data, visual acuity, fellow eye nAMD conversion rate, and the number of anti-vascular endothelial growth factor (anti-VEGF) injections in the primary eye were evaluated. Also, the nAMD-converted fellow eyes were divided into two groups based on the time of conversion (less and more than two years from the first injection in the primary eye). Based on the data types, the T-test, Chi-square, and Mann-Whitney U test were used to analyze. RESULTS The total cases were 593 patients, and 248 eyes (41.82%) converted to nAMD in the mean interval of 34.92 ± 30.62 months. The males exhibited a predisposition to wet conversion at 2.54 years earlier than their female counterparts (P = 0.025). In all the converted fellow eyes, the mean age was 2.3 years higher at presentation in the group who converted within two years of follow-up in compared to eyes that converted after two years (79.82 ± 8.64 vs 77.51 ± 8.5 years, P = 0.035). Additionally, eyes converting within two years had a mean baseline LogMAR visual acuity of 0.44 ± 0.47, compared to 0.32 ± 0.41 for conversions after two years (P = 0.014). CONCLUSION This study reported that males showed a predisposition to fellow eye nAMD conversion at an earlier age. Additionally, there was a trend of faster fellow eye nAMD conversion in individuals with higher age and lower baseline visual acuity. KEY MESSAGES What is known • Certain risk factors may make the fellow eye of neovascular age-related macular degeneration (nAMD) more likely to progress to wet conversion. • Identifying these risk factors for fellow eye wet conversion can help prevent it, potentially preserving the patient's vision quality for a longer duration. • The studies on the incidence of wet conversion in the fellow eye have yielded controversial results. What is new • During the 15-year follow-up period, nearly half (47.58%) of the fellow eyes that underwent wet conversion did so within the initial two years following the wet conversion of the first eye. • Males showed a predisposition to fellow eye nAMD conversion at an earlier age. • There was a trend of faster fellow eye nAMD conversion in individuals with higher age and lower baseline visual acuity.
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Affiliation(s)
- Elham Sadeghi
- Department of Ophthalmology, University of Pittsburgh School of Medicine, 3550 Terrace St, Pittsburgh, PA, 15213, USA
| | | | - Sandeep Chandra Bollepalli
- Department of Ophthalmology, University of Pittsburgh School of Medicine, 3550 Terrace St, Pittsburgh, PA, 15213, USA
| | - Kiran Kumar Vupparaboina
- Department of Ophthalmology, University of Pittsburgh School of Medicine, 3550 Terrace St, Pittsburgh, PA, 15213, USA
| | | | - Jose-Alain Sahel
- Department of Ophthalmology, University of Pittsburgh School of Medicine, 3550 Terrace St, Pittsburgh, PA, 15213, USA
| | - Andrew W Eller
- Department of Ophthalmology, University of Pittsburgh School of Medicine, 3550 Terrace St, Pittsburgh, PA, 15213, USA
| | - Jay Chhablani
- Department of Ophthalmology, University of Pittsburgh School of Medicine, 3550 Terrace St, Pittsburgh, PA, 15213, USA.
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Oshima Y, Shinojima A, Sawa M, Mori R, Sekiryu T, Kato A, Hara C, Saito M, Sugano Y, Hirano Y, Asato H, Nakamura M, Kimura E, Yuzawa M, Ishibashi T, Ogura Y, Iida T, Gomi F, Yasukawa T. Progression of age-related macular degeneration in eyes with abnormal fundus autofluorescence in a Japanese population: JFAM study report 3. PLoS One 2022; 17:e0264703. [PMID: 35213672 PMCID: PMC8880956 DOI: 10.1371/journal.pone.0264703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 02/15/2022] [Indexed: 11/18/2022] Open
Abstract
Purpose
To evaluate the progression of early age-related macular degeneration to neovascular age-related macular degeneration (nAMD), and identify the abnormal fundus autofluorescence (FAF) patterns and markers of choroidal neovascularization (CNV) in fellow eyes of patients with unilateral nAMD.
Methods
Sixty-six patients with unilateral nAMD who developed abnormal FAF in the fellow eyes were enrolled in this multicenter, prospective, observational study, and followed-up for 5 years. FAF images on Heidelberg Retina Angiogram Digital Angiography System (HRA) or HRA2 were classified into eight patterns based on the International Fundus Autofluorescence Classification Group system. The patients in which the fellow eyes progressed to advanced nAMD, including those who did not develop nAMD, were assessed based on the following factors: baseline FAF patterns, age, sex, visual acuity, drusen, retinal pigmentation, baseline retinal sensitivity, family history, smoking, supplement intake, hypertension, body mass index, and hematological parameters.
Results
Of the 66 patients, 20 dropped out of the study. Of the remaining 46 patients, 14 (30.42%, male: 9, female: 5) progressed to nAMD during the 5-year follow-up. The most common (50% eyes) FAF pattern in the fellow eyes was the patchy pattern. According to the univariate analysis, CNV development was significantly associated with age, supplement intake, and low-density lipoprotein levels (p<0.05). Multivariable analysis revealed that patients who showed non-compliance with the supplement intake were more likely to develop nAMD (p<0.05). No significant association was found between the patchy pattern and CNV development (p = 0.86).
Conclusion
The fellow eyes (with abnormal FAF) of patients with unilateral nAMD may progress from early to advanced nAMD. However, no FAF pattern was found that predicted progression in nAMD.
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Affiliation(s)
- Yuji Oshima
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Department of Medicine, Section of Ophthalmology, Fukuoka Dental College, Fukuoka, Japan
| | - Ari Shinojima
- Division of Ophthalmology, Department of Visual Sciences, Nihon University School of Medicine, Tokyo, Japan
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Miki Sawa
- Department of Ophthalmology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Ryusaburo Mori
- Division of Ophthalmology, Department of Visual Sciences, Nihon University School of Medicine, Tokyo, Japan
| | - Tetsuju Sekiryu
- Department of Ophthalmology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Aki Kato
- Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Chikako Hara
- Department of Ophthalmology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Masaaki Saito
- Department of Ophthalmology, Fukushima Medical University School of Medicine, Fukushima, Japan
- Department of Ophthalmology, Graduate School of Medicine and Faculty of Medicine, Akita University, Akita, Japan
| | - Yukinori Sugano
- Department of Ophthalmology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Yoshio Hirano
- Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Hitomi Asato
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | | | - Erika Kimura
- Santen Pharmaceutical Co., Ltd., Ikoma, Japan
- Santen-SERI Open Innovation Centre, Singapore, Singapore
| | - Mitsuko Yuzawa
- Division of Ophthalmology, Department of Visual Sciences, Nihon University School of Medicine, Tokyo, Japan
| | - Tatsuro Ishibashi
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yuichiro Ogura
- Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Tomohiro Iida
- Department of Ophthalmology, Fukushima Medical University School of Medicine, Fukushima, Japan
- Department of Ophthalmology, Tokyo Women’s Medical University, Tokyo, Japan
| | - Fumi Gomi
- Department of Ophthalmology, Osaka University Graduate School of Medicine, Suita, Japan
- Department of Ophthalmology, Hyogo College of Medicine, Nishinomiya, Japan
| | - Tsutomu Yasukawa
- Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
- * E-mail:
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