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Randomized Controlled Trial
. 2014 Jul;158(1):128-135.e10.
doi: 10.1016/j.ajo.2014.04.004. Epub 2014 Apr 13.

Sporadic visual acuity loss in the Comparison of Age-Related Macular Degeneration Treatments Trials (CATT)

Benjamin J Kim  1 , Gui-Shuang Ying  2 , Jiayan Huang  2 , Nicole E Levy  2 , Maureen G Maguire  2 ; CATT Research Group
Collaborators, Affiliations
Randomized Controlled Trial

Sporadic visual acuity loss in the Comparison of Age-Related Macular Degeneration Treatments Trials (CATT)

Benjamin J Kim et al. Am J Ophthalmol. 2014 Jul.

Abstract

Purpose: To evaluate transient, large visual acuity (VA) decreases, termed sporadic vision loss, during anti-vascular endothelial growth factor treatment for neovascular age-related macular degeneration (AMD).

Design: Cohort within a randomized clinical trial.

Methods: setting: Comparison of Age-Related Macular Degeneration Treatments Trials (CATT). study population: Total of 1185 CATT patients. main outcome measures: Incidence of sporadic vision loss and odds ratio (OR) for association with patient and ocular factors. Sporadic vision loss was a decline of ≥15 letters from the previous visit, followed by a return at the next visit to no more than 5 letters worse than the visit before the VA loss.

Results: There were 143 sporadic vision loss events in 122 of 1185 patients (10.3%). Mean VA at 2 years for those with and without sporadic vision loss was 58.5 (∼20/63) and 68.4 (∼20/40) letters, respectively (P < .001). Among patients treated pro re nata, no injection was given for 27.6% (27/98) of sporadic vision loss events. Multivariate analysis demonstrated that baseline predictors for sporadic vision loss included worse baseline VA (OR 2.92, 95% confidence interval [CI]:1.65-5.17 for ≤20/200 compared with ≥20/40), scar (OR 2.21, 95% CI:1.22-4.01), intraretinal foveal fluid on optical coherence tomography (OR 1.80, 95% CI:1.11-2.91), and medical history of anxiety (OR 1.90, 95% CI:1.12-3.24) and syncope (OR 2.75, 95% CI:1.45-5.22). Refraction decreased the likelihood of sporadic vision loss (OR 0.62, 95%CI: 0.42-0.91).

Conclusions: Approximately 10% of CATT patients had sporadic vision loss. Baseline predictors included AMD-related factors and factors independent of AMD. These data are relevant for clinicians in practice and those involved in clinical trials.

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Conflict of interest statement

ALL AUTHORS HAVE COMPLETED AND SUBMITTED THE ICMJE FORM FOR DISCLOSURE OF POTENTIAL CONFLICTS OF INTEREST. The authors indicate the following financial disclosures: BJK has been on advisory boards for Thrombogenics, Eyetech, and Allergan. The other authors have no financial disclosures.

Figures

Figure
Figure
Mean (+/− standard error) visual acuity over 2 years among patients with and without sporadic vision loss in the Comparison of Age-Related Macular Degeneration Treatments Trials. Study visits with refraction are represented by solid symbols.
See this image and copyright information in PMC

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