Evidence map›Paper›PMID 24314839›Full record

Trial reportOphthalmology2014

Risk of scar in the comparison of age-related macular degeneration treatments trials.

Ebenezer Daniel, Cynthia A Toth, Juan E Grunwald, Glenn J Jaffe, Daniel F Martin, Stuart L Fine, Jiayan Huang, Gui-shuang Ying, Stephanie A Hagstrom, Katrina Winter and 2 more

Registry-linked trialOpen access · bronzeAbstract readComparative StudyMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Ophthalmology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00593450 (Comparison of Age-related Macular Degeneration Treatments Trials), which is not on this map. Cited by 186 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
186citing papers in PubMed, 3 pooled it
10.0field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00593450 phase3completednot on this map

Comparison of Age-related Macular Degeneration Treatments Trials: Lucentis-Avastin Trial (CATT)

TypeinterventionalSponsorUniversity of PennsylvaniaRan2008 to 2015Enrolled1,208ConditionsAge Related Macular DegenerationArmsranibizumab, bevacizumab
3 · Its place in the literature

Who cites it

186 citing papers in PubMed, 3 syntheses or guidelines pooled it, 319 citations in OpenAlex.

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  6. Macular neovascularization lesion type and vision outcomes in neovascular age-related macular degeneration: post hoc analysis of HARBOR.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2022
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126 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 5 institutions in 1 country.

Ebenezer DanielDepartment of Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania. Electronic address: ebdaniel@mail.med.upenn.edu.
Cynthia A TothDepartment of Ophthalmology, Duke University, Durham, North Carolina.
Juan E GrunwaldDepartment of Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania.
Glenn J JaffeDepartment of Ophthalmology, Duke University, Durham, North Carolina.
Daniel F MartinCole Eye Institute, Cleveland Clinic, Cleveland, Ohio.
Stuart L FineDepartment of Ophthalmology, University of Colorado-Denver, Aurora, Colorado.
Jiayan HuangDepartment of Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania.
Gui-shuang YingDepartment of Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania.
Stephanie A HagstromCole Eye Institute, Cleveland Clinic, Cleveland, Ohio.
Katrina WinterDepartment of Ophthalmology, Duke University, Durham, North Carolina.
Maureen G MaguireDepartment of Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania.
Comparison of Age-related Macular Degeneration Treatments Trials Research Group
University of Pennsylvania · USDuke University · USCleveland Clinic · USCleveland Eye Clinic · USUniversity of Colorado Denver · US

Funding

Coordinating Center for the Comparison of AMD Treatments TrialsU10EY017823 · NEI · UNIVERSITY OF PENNSYLVANIA · PI MAGUIRE, MAUREEN G · 2006 to 2012
$19.2M
Photograph Reading Center for the Comparison of AMD Treatment TrialsU10EY017826 · NEI · UNIVERSITY OF PENNSYLVANIA · PI GRUNWALD, JUAN E · 2006 to 2013
$2.8M
Comparison of AMD Treatment Trials-OCT Reading CenterU10EY017825 · NEI · DUKE UNIVERSITY · PI JAFFE, GLENN · 2006 to 2013
$2.3M
Chair Grant for the Comparison of AMD Treatment TrialsU10EY017828 · NEI · EMORY UNIVERSITY · PI MARTIN, DANIEL F · 2006 to 2012
$1.9M
NEI NIH HHS U10 EY017823NEI NIH HHS U10 EY017825NEI NIH HHS U10 EY017826NEI NIH HHS U10 EY017828
6 · The paper itself

Abstract

objectiveTo describe risk factors for scar in eyes treated with ranibizumab or bevacizumab for neovascular age-related macular degeneration (AMD).

designProspective cohort study within a randomized clinical trial.

participantsPatients with no scar on color fundus photography (CFP) or fluorescein angiography (FA) at enrollment in the Comparison of Age-related Macular Degeneration Treatments Trials (CATT).

methodsEyes were assigned to ranibizumab or bevacizumab treatment and to 1 of 3 dosing regimens for 2 years. Masked readers assessed CFP and FA. Baseline demographic characteristics, visual acuity, morphologic features on photography and optical coherence tomography (OCT), and genotypes associated with AMD risk were evaluated as risk factors using adjusted hazard ratios (aHRs) and associated 95% confidence intervals (CIs). Scars were classified as fibrotic with well-demarcated elevated mounds of yellowish white tissue or nonfibrotic with discrete flat areas of hyperpigmentation with varying amounts of central depigmentation.

main outcome measuresScar formation.

resultsScar developed in 480 of 1059 eyes (45.3%) by 2 years. Baseline characteristics associated with greater risk of scarring were predominantly classic choroidal neovascularization (CNV) (aHR, 3.1; CI, 2.4-3.9) versus occult CNV, blocked fluorescence (aHR, 1.4; CI, 1.1-1.8), foveal retinal thickness >212 μm (aHR, 2.4; CI, 1.7-3.6) versus <120 μm, foveal subretinal tissue complex thickness >275 μm (aHR, 2.4; CI, 1.7-3.6) versus ≤75 μm, foveal subretinal fluid (aHR, 1.5; CI, 1.1-2.0) versus no subretinal fluid, and subretinal hyperreflective material (SHRM) (aHR, 1.7; CI, 1.3-2.3) versus no SHRM. Eyes with elevation of the retinal pigment epithelium had lower risk (aHR, 0.6; CI, 0.5-0.8) versus no elevation. Drug, dosing regimen, and genotype had no statistically significant association with scarring. Fibrotic scars developed in 24.7% of eyes, and nonfibrotic scars developed in 20.6% of eyes. Baseline risk factors for the scar types were similar except that eyes with larger lesion size or visual acuity <20/40 were more likely to develop fibrotic scars.

conclusionsApproximately half of eyes enrolled in CATT developed scar by 2 years. Eyes with classic neovascularization, a thicker retina, and more fluid or material under the foveal center of the retina are more likely to develop scar.

Indexed as

Postoperative ComplicationsAngiogenesis InhibitorsAntibodies, Monoclonal, HumanizedBevacizumabCicatrixCohort StudiesFemaleFibrosisFluorescein AngiographyGenotypeHumansIncidenceIntravitreal InjectionsMaleMiddle AgedProspective StudiesAngiogenesis InhibitorsAntibodies, Monoclonal, HumanizedBevacizumabRanibizumabVascular Endothelial Growth Factor AVEGFA protein, human

Identifiers

PMID24314839
PMCPMC3943618
OpenAlexW2063028754

What OpenQuestion holds

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LicenceTDM
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.