Risk factors for second eye progression to advanced age-related macular degeneration: SST report No. 21 Submacular Surgery Trials Research Group.
OBJECTIVE
To identify characteristics predictive of progression to advanced age-related macular degeneration (AMD) in second (fellow) eyes of participants in the Submacular Surgery Trials (SST) who had unilateral neovascular AMD at study entry.


METHODS
Review of baseline fluorescein angiograms confirmed the absence of advanced AMD in 370 fellow eyes. All participants were eligible for 2 years of follow-up; follow-up angiograms of eyes at risk were evaluated to estimate incidence rates of advanced AMD. Baseline nonocular and ocular AMD characteristics were evaluated to identify those that predicted development of advanced AMD.


RESULTS
Of 110 eyes that progressed to advanced AMD, choroidal neovascularization (CNV) developed in 98 eyes and foveal geographic atrophy (GA) in 15 eyes. No nonocular characteristic (age, gender, history of hypertension or smoking) or ocular feature of the study eye at baseline (lesion composition, lesion size, or visual acuity) was predictive of progression to advanced AMD in this cohort. Multivariate analysis identified three baseline fellow eye ocular features that had a significant and independent relationship with progression to advanced AMD: drusen size, focal hyperpigmentation, and nonfoveal GA.


CONCLUSIONS
Recognition of factors that predict advanced AMD in the second eye may identify those individuals at greater risk of progression so that treatment can be provided before vision is severely compromised.
Solomon
Sharon D
SD
Jefferys
Joan L
JL
Hawkins
Barbara S
BS
Bressler
Neil M
NM
Bressler
Susan B
SB
D000368:Aged; D000369:Aged, 80 and over; D018450:Disease Progression; D005123:Eye / Q000473:pathology / Q000503:physiopathology; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D017495:Hyperpigmentation / Q000209:etiology / Q000473:pathology; D015994:Incidence; D008268:Macular Degeneration / Q000150:complications / Q000453:epidemiology* / Q000473:pathology; D008297:Male; D015593:Retinal Drusen / Q000209:etiology / Q000473:pathology; D012307:Risk Factors