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SST Report No. 20 From the Submacular Surgery Trials Research Group

Submacular Surgery Trials Research Group^*

Arch Ophthalmol. 2007;125(10):1323-1330.

Objective  To describe incident choroidal neovascular lesions in fellow eyes of participants in the Submacular Surgery Trials who had age-related macular degeneration (AMD).

Methods  Review of baseline fluorescein angiograms confirmed the absence of neovascular AMD in fellow eyes of 364 participants at risk. Subjects were eligible for a minimum of 2 years of follow-up with angiograms of eyes at risk reevaluated to estimate incidence rates of choroidal neovascularization (CNV) and to characterize these lesions.

Main Outcome Measures  Incidence of CNV during follow-up, characteristics of the incident lesion (composition, size, and location), and visual acuity at the time of incidence.

Results  Incident lesions were confirmed in 98 fellow eyes of participants, yielding 2- and 4-year cumulative incidence rates of 22% and 37%. Incident lesions were predominantly CNV in 87 fellow eyes (90%), extrafoveal in 29 fellow eyes (30%), and juxtafoveal in 9 fellow eyes (9%). Occult without classic CNV lesions were found in 64 eyes (67%), minimally classic CNV and predominantly classic CNV lesions in 12 eyes (13%) each, and predominantly blood lesions in 4 eyes (4%). Nearly two-thirds of all incident lesions were 3 disc areas or smaller in size. Median visual acuity decreased from 20/25 at baseline to 20/250 at the 4-year follow-up in fellow eyes with incident CNV.

Conclusions and Application to Clinical Practice  Frequent angiographic follow-up of fellow eyes at risk for CNV may lead to earlier detection and treatment of neovascular AMD and better visual acuity outcomes.

Trial Registration  clinicaltrials.gov Identifier: NCT00000150

*Authors/Writing Committee: This article was prepared by the following members of the Submacular Surgery Trials Research Group: Sharon D Solomon, MD; Barbara S Hawkins, PhD; Joan L Jefferys, ScM; Neil M. Bressler, MD; Susan B Bressler, MD; Johns Hopkins University School of Medicine and Wilmer Eye Institute, Baltimore, Maryland.
Group Information: A list of the members of the Submacular Surgery Trials (SST) Research Group was published in Arch Ophthalmol. 2004;122(11):1597-1611.