Comparison of Fundus Autofluorescence Versus Optical Coherence Tomography-based Evaluation of the Therapeutic Response to Pegcetacoplan in Geographic Atrophy.

Abstract

PURPOSE:

To perform an optical coherence tomography (OCT)-based analysis of geographic atrophy (GA) progression in patients treated with pegcetacoplan.

DESIGN:

Post hoc analysis of a phase 2 multicenter, randomized, sham-controlled trial.

METHODS:

Manual annotation of retinal pigment epithelium (RPE), ellipsoid zone (EZ), and external limiting membrane (ELM) loss was performed on OCT volumes from baseline and month 12 from the phase 2 FILLY trial of intravitreal pegcetacoplan for the treatment of GA secondary to age-related macular degeneration.

MAIN OUTCOME MEASURES:

Correlation of GA areas measured on fundus autofluorescence and OCT. Difference in square root transformed growth rates of RPE, EZ, and ELM loss between treatment groups (monthly injection [AM], injection every other month [AEOM], and sham [SM]).

RESULTS:

OCT volumes from 113 eyes of 113 patients (38 AM, 36 AEOM, and 39 SM) were included, resulting in 11 074 B-scans. The median growth of RPE loss was significantly slower in the AM group (0.158 [0.057-0.296]) than the SM group (0.255 [0.188-0.359], P = .014). Importantly, the growth of EZ loss was also significantly slower in the AM group (0.127 [0.041-0.247]) than the SM group (0.232 [0.130-0.349], P = .017). There was no significant difference in the growth of ELM loss between the treatment groups (P = .114).

CONCLUSIONS:

OCT imaging provided consistent results for GA growth compared with fundus autofluorescence. In addition to slower RPE atrophy progression in patients treated with pegcetacoplan, a significant reduction in EZ impairment was also identified by OCT, suggesting the use of OCT as a potentially more sensitive monitoring tool in GA therapy.

• Authors: Julia Mai, Sophie Riedl, Gregor S Reiter, Dmitrii Lachinov, Wolf-Dieter Vogl, Hrvoje Bogunovic, Ursula Schmidt-Erfurth
• Journal: American journal of ophthalmology (Am J Ophthalmol) Vol. 244 Pg. 175-182 (12 2022) ISSN: 1879-1891 [Electronic] United States
• PMID: 35853489 (Publication Type: Randomized Controlled Trial, Multicenter Study, Clinical Trial, Phase II, Journal Article)
• Copyright: Copyright © 2022 Elsevier Inc. All rights reserved.

Chemical References

• pegcetacoplan

Topics

• Humans
• Fluorescein Angiography (methods)
• Geographic Atrophy (diagnosis, drug therapy)
• Retinal Pigment Epithelium
• Tomography, Optical Coherence (methods)
• Visual Acuity