Moorfields AMD database report 2: fellow eye involvement with neovascular age-related macular degeneration.

Background/aims: Neovascular age-related macular degeneration (nAMD) is frequently bilateral, and previous reports on 'fellow eyes' have assumed sequential treatment after a period of treatment of the first eye only. The aim of our study was to analyse baseline characteristics and visual acuity (VA) outcomes of fellow eye involvement with nAMD, specifically differentiating between sequential and non-sequential (due to macular scarring in the first eye) antivascular endothelial growth factor treatment and timelines for fellow eye involvement.
Methods: Retrospective, electronic medical record database study of the Moorfields AMD database of 6265 patients/120 286 single entries with data extracted between 21 October 2008 and 9 August 2018. The data set for analysis consisted of 1180 sequential, 807 non-sequential and 3410 unilateral eyes.
Results: Mean VA (ETDRS letters±SD) of sequentially treated fellow eyes at baseline was significantly higher (63±13), VA gain over 2 years lower (0.37±14) and proportion of eyes with good VA (≥70 letters) higher (46%) than the respective first eyes (baseline VA 54±16, VA gain at 2 years 5.6±15, percentage of eyes with good VA 39%). Non-sequential fellow eyes showed baseline characteristics and VA outcomes similar to first eyes. Fellow eye involvement rate was 32% at 2 years, and median time interval to fellow eye involvement was 71 (IQR: 27-147) weeks.
Conclusion: This report shows that sequentially treated nAMD fellow eyes have better baseline and final VA than non-sequentially treated eyes after 2 years of treatment. Sequentially treated eyes also had a greater proportion with good VA after 2 years.
Competing Interests: Competing interests: KF has received fellowship support from Alfred Vogt Stipendium and Schweizerischer Fonds zur Verhütung und Bekämpfung der Blindheit. She has been an external consultant for DeepMind. SW is an academic clinical fellow funded by the National Institute of Health Research (NIHR). PAK has received speaker fees from Heidelberg Engineering, Topcon, Carl Zeiss Meditec, Haag-Streit, Allergan, Novartis and Bayer. He has served on advisory boards for Novartis and Bayer and has been an external consultant for DeepMind and Optos. PAK is supported by a UK NIHR Clinician Scientist Award (NIHR-CS-2014-12-023). RC received studentship support from the College of Optometrists and is a paid intern at DeepMind. PJP has received speaker fees from Novartis UK, Bayer UK and Roche UK and has received an advisory board honorarium from Novartis UK and Bayer UK. AYL has received research funding from Novartis, NVIDIA and Microsoft Corporation. He is supported by the National Institutes of Health (K23EY029246) and Research to Prevent Blindness.
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