Long-term progression of geographic atrophy in age-related macular degeneration does the phakic status matter?

Autores da FMUP

• Rodrigo Manuel Robalo Curado De Vilares Morgado

  Autor

• João Nuno Bicho Beato

  Autor

• Angela Maria Veloso Guimarães Carneiro

  Autor

• Fernando Manuel Mendes Falcão Reis

  Autor

• Manuel Alberto De Almeida E Sousa Falcão

  Autor

Participantes de fora da FMUP

• Madeira, C
• Godinho, G
• Pinheiro-Costa, J

Unidades de investigação

• Cirurgia e Fisiologia

• Laboratório Associado RISE- Rede de Investigação em Saúde

  

  Investigador

  Fernando Carlos De Landér Schmitt

• RISE-Health

  

  Investigador

  Fernando Carlos De Landér Schmitt

Abstract

Purpose To assess the long-term risk of geographic atrophy (GA) progression after cataract surgery. Methods Subjects with GA secondary to AMD followed for at least 1 year with fundus autofluorescence imaging and with at least two visits at our centre were included. Patients with wet AMD, disciform scar, past history of intravitreal injections or laser treatment, other maculopathies and with poor quality images were excluded. GA area at baseline and at follow-up visit was measured. Three study groups were defined according to their phakic status: (A) pseudophakia, (B) phakic and (C) phacoemulsification surgery performed during the study. Differences of GA area progression were compared between these study groups. In addition, comparison between GA progression rate in group (C) before and after the surgery was performed. The enlargement rate (ER) was calculated for lesion size after transforming the measurements to the square-root scale. Results A total of 92 eyes of 92 patients were enrolled. Median follow-up time was 4 [1-10] years. Regarding the eye's phakic status, 29 (31.5%) were pseudophakic and 63 (68.5%) were phakic; of these, 22 underwent phacoemulsification during the study. Overall, the median baseline and follow-up area of GA were 1.42 [0.04-32.10] mm(2) and 6.48 [0.25-47.40] mm(2), respectively. The ER was similar between phakic and pseudophakic eyes (0.18 [0.01-1.03] vs 0.15 [0.01-0.65] mm/year, p = 0.62). In patients that underwent cataract surgery during the study, the GA ER remained stable (0.13 [0.01-0.92] vs 0.14 [0.01-0.63] mm/year, p = 0.43). Conclusion These results suggest that cataract surgery does not increase the risk of pre-existing GA progression. Therefore, cataract surgery seems safe and a potential therapeutic weapon to improve visual acuity and consequently quality of life in GA patients.

Keywords

• Cataract surgery; Fundus autofluorescence; Geographic atrophy; Phacoemulsification; Phakic; Progression; Pseudophakic