1 Macular Morphology and Visual Macular Morphology and Visual Acuity in the Comparison of Acuity in the Comparison of Age-related Macular Age-related Macular Degeneration Treatments Trial Degeneration Treatments Trial (CATT) (CATT) Jaffe GJ, Martin DF, Toth CA, Daniel E, Jaffe GJ, Martin DF, Toth CA, Daniel E, Maguire, MG, Maguire, MG, Ying G-S, Grunwald JE, Huang J for the CATT Ying G-S, Grunwald JE, Huang J for the CATT Research Team Research Team Supported by Cooperative Agreements from the Supported by Cooperative Agreements from the National Eye Institute, National Institutes of Health, National Eye Institute, National Institutes of Health, DHHS DHHS Available through Available through http://www.med.upenn.edu/cpob/publications_ma in.shtml
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1 Macular Morphology and Visual Acuity in the Comparison of Age-related Macular Degeneration Treatments Trial (CATT) Jaffe GJ, Martin DF, Toth CA, Daniel.
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Macular Morphology and Visual Macular Morphology and Visual Acuity in the Comparison of Acuity in the Comparison of
(CATT)(CATT)Jaffe GJ, Martin DF, Toth CA, Daniel E, Maguire, MG, Jaffe GJ, Martin DF, Toth CA, Daniel E, Maguire, MG,
Ying G-S, Grunwald JE, Huang J for the CATT Research Ying G-S, Grunwald JE, Huang J for the CATT Research Team Team
Jaffe GJ, Martin DF, Toth CA, Daniel E, Maguire, MG, Jaffe GJ, Martin DF, Toth CA, Daniel E, Maguire, MG, Ying G-S, Grunwald JE, Huang J for the CATT Research Ying G-S, Grunwald JE, Huang J for the CATT Research Team Team
Supported by Cooperative Agreements from the Supported by Cooperative Agreements from the National Eye Institute, National Institutes of National Eye Institute, National Institutes of
Health, DHHSHealth, DHHS
Available through Available through http://www.med.upenn.edu/cpob/publications_main.shtml
Jaffe et al. Macular Morphology and Visual Acuity in the Comparison of Age-related Macular Degeneration Treatments Trials Ophthalmology Epub 2013 May 03
Impact Over Time of Drug & Dosing Impact Over Time of Drug & Dosing Regimen on OCT–Determined Thickness Regimen on OCT–Determined Thickness MeasurementsMeasurements
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Jaffe et al. Macular Morphology and Visual Acuity in the Comparison of Age-related Macular Degeneration Treatments Trials Ophthalmology Epub 2013 May 03
Retinal thickness category Retinal thickness category over time by treatment over time by treatment
groupgroup
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Jaffe et al. Macular Morphology and Visual Acuity in the Comparison of Age-related Macular Degeneration Treatments Trials Ophthalmology Epub 2013 May 03
Lesion Components Under the Foveal Center by Drug and Dosing Regimen
5Jaffe et al. Macular Morphology and Visual Acuity in the Comparison of Age-related Macular Degeneration Treatments Trials Ophthalmology Epub 2013 May 03
Jaffe et al. Macular Morphology and Visual Acuity in the Comparison of Age-related Macular Degeneration Treatments Trials Ophthalmology Epub 2013 May 03
Baseline
Week 52
Involvement of the foveal center by Involvement of the foveal center by CNV or sequelae of CNV at week 52 CNV or sequelae of CNV at week 52
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(A) Ranibizumab Monthly
(B) Bevacizumab Monthly
(C) Ranibizumab PRN
(D) Bevacizumab PRN
Fluid Only10.9%
CNV21.5%
SPED0.4%
Scar16.2%RPE Tears
1.5%Other2.3%
No Pathology17.7%
Can't Grade3.0%
Blocked Fluorescence
5.3%
Non-geographic Atrophy
18.5%
Geographic Atrophy
2.6%Fluid Only 8.2%
CNV 21.2%
SPED 0.4%
Scar 20.4%RPE Tears 0.8%
Other 4.9%
No Pathology 24.9%
Can't Grade 1.6%
Blocked Fluorescence
4.9%
Non-geographic Atrophy 11.8%
Geographic Atrophy 0.8%
Fluid Only 4.5%
CNV 26.5%
SPED 1.1%
Scar 19.0%Hemorrhage
0.7%RPE Tear 0.7%
Other 4.8%
No Pathology 20.1%
Can't Grade 3.4%
Blocked Fluorescence
3.4%
Non-geographic Atrophy 14.5%
Geographic Atrophy 1.1% Fluid Only 9.4%
CNV 29.8%
SPED 0.4%
Scar 18.8%
Hemorrhage 0.4%
RPE Tears 0.8%
Other 3.9%
No Pathology 16.1%
Can't Grade 2.4%
Blocked Fluorescence
1.6%
Non-geographic Atrophy 13.3%
Geographic Atrophy 3.1%
Mean visual acuity by status of fluid
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Jaffe et al. Macular Morphology and Visual Acuity in the Comparison of Age-related Macular Degeneration Treatments Trials Ophthalmology Epub 2013 May 03
Retinal thickness and Visual Acuity Retinal thickness and Visual Acuity at Baseline and Follow-upat Baseline and Follow-up
9Jaffe et al. Macular Morphology and Visual Acuity in the Comparison of Age-related Macular Degeneration Treatments Trials Ophthalmology Epub 2013 May 03
Nonlinear relationship of visual Nonlinear relationship of visual acuity with foveal total thickness acuity with foveal total thickness
during follow-up during follow-up
10Jaffe et al. Macular Morphology and Visual Acuity in the Comparison of Age-related Macular Degeneration Treatments Trials Ophthalmology Epub 2013 May 03
Mean VA by Neovascular Lesion Area and Pathology in Foveal Center at Week 52
(N=1053)
11Jaffe et al. Macular Morphology and Visual Acuity in the Comparison of Age-related Macular Degeneration Treatments Trials Ophthalmology Epub 2013 May 03
Fundus Feature at Week 52 N
Unadjusted Mean Visual Acuity
Score (Standard Error)
P values*
Neovascular lesion area (mm2) <0.0001
≥0 to ≤1.92 244 74.3 (1.11) >1.92 to ≤4.96 246 70.4 (1.10) >4.96 to ≤9.62 245 67.1 (1.10) >9.62 242 61.9 (1.11)
Missing 76 63.1 (1.98) Pathology in foveal center <0.0001
None 202 73.9 (1.20) Fluid only 85 75.3 (1.85) Choroidal
neovascularization or serous pigment epithelium detachment
Scar 188 59.5 (1.25) Other§ or missing 96 66.8 (1.75) *1-way analysis of variance
RPE = retinal pigment epithelium§Other includes pigment, drusenoid pigment epithelial detachment and non-leaking choroidal neovascularization
Adjusted Mean Visual Acuity for OCT and Fundus Features at Week 52 (n=1004)∗
12Jaffe et al. Macular Morphology and Visual Acuity in the Comparison of Age-related Macular Degeneration Treatments Trials Ophthalmology Epub 2013 May 03
*Subjects (n=49) with missing data for fluid or retinal thickness were excluded.CNV= choroidal neovascularizationRPE = retinal pigment epithelium
ConclusionsConclusions
Anti–vascular endothelial growth factor (VEGF) therapy Anti–vascular endothelial growth factor (VEGF) therapy reduced lesion activity and improved VA in all treatment reduced lesion activity and improved VA in all treatment groups. groups.
At all time points, eyes with residual IRF had worse VA than At all time points, eyes with residual IRF had worse VA than those without.those without.
Eyes with abnormally thin or thick retinas, residual large Eyes with abnormally thin or thick retinas, residual large lesions, and scar also had worse VA.lesions, and scar also had worse VA.
Monthly ranibizumab dosing yielded more eyes with no fluid Monthly ranibizumab dosing yielded more eyes with no fluid and an abnormally thin retina, although the long-term and an abnormally thin retina, although the long-term significance is unknown.significance is unknown.
These results have important treatment implications in eyes These results have important treatment implications in eyes undergoing anti-VEGF therapy for neovascular undergoing anti-VEGF therapy for neovascular
Jaffe et al. Macular Morphology and Visual Acuity in the Comparison of Age-related Macular Degeneration Treatments Trials Ophthalmology Epub 2013 May 03