Neovascularization May Protect Against Macular Atrophy Progression

Macular neovascularization (MVN) may have a protective effect against the progression of macular atrophy (MA) in patients with age-related macular degeneration (AMD), according to research published in Ophthalmology Retina. 

Researchers conducted a retrospective, longitudinal comparative case series of 117 eyes of 95 patients (mean age 77.8±10.18 years, 73.68% women) with AMD. The cohort consisted of individuals with geographic atrophy (GA) (n=61) or MA with MNV (n=56). Among the MA cohort, 50% had type 1 MNV, 12.5% had type 2 MNV, and 37.5% had type 3 MNV. 

The team performed fundus autofluorescence, near infrared reflectance, and optical coherence tomography (OCT) imaging on all participants at baseline and at follow-up visits every 6±3 months for 2 years, and 12±3 months thereafter for a period of 5 years to calculate atrophy growth rates.  

The investigators observed similar baseline lesion sizes in both cohorts (1.74 vs 1.53 mm², P =.56). However, they noted greater overall enlargement rates and area of atrophy growth in the GA cohort at 5 year follow-up compared with the MA arm (1.72 vs 1.32 mm²/year, P =.002 and +8.06 vs +4.55 mm², P =.001, respectively).

The researchers attribute their findings to a protective effect of MNV against the expansion of MA, but admit “it is unclear whether these benefits are sustained in the long-term.”

Study limitations include a single center design, a retrospective nature, and a lack of OCT-angiography images at each follow-up visit. 

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or clinical research organizations. Please see the original reference for a full list of disclosures.

Reference

Airaldi M, Corvi F, Cozzi M, Nittala MG, Staurenghi G, Sadda SR. Differences in long-term progression of atrophy between neovascular and non-neovascular age-related macular degeneration. Ophthalmol Retina. Published online April 20, 2022. doi:10.1016/j.oret.2022.04.012