June 5, 2020 Conference


Oral AREDS Supplements (Antioxidants and Zinc) Do Not Significantly Affect the Geographic Atrophy Growth Rate in the Central Zone

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Mr. Liangbo (Linus) Shen, Yale School of Medicine, Yale University (Presenter)
Ms. Mengyuan Sun, Department of Molecular Biophysics and Biochemistry, Yale University
Ms. Aneesha Ahluwalia, Yale University School of Medicine
Dr. Benjamin Young, Yale University Department of Ophthalmology and Visual Sciences
Michael Park, Yale University Department of Ophthalmology and Visual Sciences
Dr. Lucian Del Priore
Purpose: Previous studies demonstrated that the total GA area was a poor predictor of visual acuity,1-3 but it is unclear if GA area in a macular subfield can provide a much better predictive power for visual acuity. Moreover, the impact of oral antioxidants on GA progression in the macular center is unknown. Methods: We manually segmented GA lesions on 1654 visits of 365 eyes with GA using data from the Age-Related Eye Disease Study (AREDS). We determined GA areas in 9 macular subfields (defined by the Early Treatment Diabetic Retinopathy Study grid) and correlated them with VA using a multivariate linear mixed model. Patients were assigned by AREDS into 1 of 4 oral supplements (placebo, antioxidants, zinc, and antioxidants plus zinc). Results: The total GA area correlated poorly with VA (r2 = 0.07). Among 9 subfields, only the central zone had a significant association between GA area and VA (P < 0.001). By varying the diameter of the central zone from 0 to 10 mm, we determined 1 mm as the optimal diameter for the central zone that had the highest correlation (r2) with VA (r2 = 0.45). The decline rate of central residual area was comparable between placebo and supplements (placebo: 0.074 mm2/year [95%CI = 0.059-0.090]; antioxidants: 0.067 mm2/year [95%CI = 0.049-0.086]; zinc: 0.066 mm2/year [95%CI = 0.051-0.082]; antioxidants + zinc: 0.061 mm2/year [95%CI = 0.046-0.078]; P = 0.41-0.64). Conclusion: GA area in the central 1 mm zone is significantly correlated with VA and may serve as a surrogate anatomic endpoint in trials. Oral supplements do not affect the GA growth rate within the central 1 mm zone.
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