This study analyzed data from the lampalizumab phase 3 trials and an observational study to examine factors affecting visual loss in patients with geographic atrophy (GA) secondary to age-related macular degeneration. The researchers assessed correlations between baseline best-corrected visual acuity (BCVA), GA lesion area, growth rate, foveal involvement, and focality with changes in BCVA over 2 years.
Key findings:
– Baseline BCVA and GA area did not correlate with BCVA changes at any timepoint
– GA growth rate showed a weak correlation with BCVA loss that increased over time
– Faster GA growth rates were associated with accelerated BCVA loss, especially in eyes with subfoveal, unifocal lesions
– By 2 years, approximately 75% of eyes lost ≥۵ letters, 50% lost ≥۱۰ letters, and 25% lost ≥۱۵ letters
– GA foveal involvement and focality correlated with rate of BCVA loss
– Subfoveal lesions, particularly unifocal ones, were at highest risk of vision loss over time
Methods included monthly BCVA assessments, fundus autofluorescence imaging every 6 months, calculation of lesion growth rates, analysis of BCVA changes by growth rate quartiles and lesion characteristics, and time-to-event analysis for different levels of letter loss.
The results suggest that while baseline BCVA and lesion size are not predictive, faster GA progression, subfoveal location, and unifocal lesions are associated with greater risk of vision loss in GA patients.
This information may help identify high-risk patients and guide management strategies. Further research is needed to develop interventions that can slow GA progression and preserve vision in these patients.
