PURPOSE To evaluate the development and rate of growth in macular atrophy after intravitreal injections of aflibercept (IVAs) for neovascular age-related macular degeneration (AMD) over a 2-year period. STUDY DESIGN Retrospective, interventional, consecutive case series. METHODS This study included 94 eyes of 92 patients with treatment-naïve AMD involving the foveal center treated with IVAs at 3 university hospitals in Japan. The patients underwent IVAs bimonthly after 3 initial monthly doses in the first year. The protocol was converted to a treat-and-extend regimen in the second year. The incidence and growth rate of macular atrophy were quantified based on hypoautofluorescence detected by fundus autofluorescence images. Additionally, possible background factors related to the development and rate of growth of macular atrophy were investigated. RESULTS Of 94 eyes, 39 (41.5%) had typical AMD and 55 (58.5%) had polypoidal choroidal vasculopathy. Ten eyes (10.6%) had macular atrophy at the baseline. Of the remaining 84 eyes, 14 (16.7%) had developed new macular atrophy at 2 years, the square root of the growth rate of atrophy was 0.52 mm/year. In multivariate analyses, a poorer best-corrected visual acuity (P = 0.01) and the presence of intraretinal fluid (P = 0.04) at baseline were found to be the independent predictors for the development of macular atrophy. No factors were found that were significantly related to the growth rate of the macular atrophy. CONCLUSIONS Our study determined the incidence and rate of growth of macular atrophy after IVAs for neovascular AMD in clinical settings. Eyes with vision reduction and intraretinal fluid at the baseline develop macular atrophy more frequently after IVAs for neovascular AMD.

中文翻译：

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阿柏西普治疗新血管性年龄相关性黄斑变性后的黄斑萎缩：日本多中心研究的结果。

目的评估玻璃体腔注射阿柏西普（IVA）治疗新生血管性年龄相关性黄斑变性（AMD）后两年内黄斑萎缩的发展和增长率。研究设计回顾性，介入性，连续病例系列。方法该研究包括日本3所大学医院的92例初治AMD患者的94眼，这些患者均接受了用IVA治疗的中央凹中心。患者在第一年每月3次初始剂量后每两个月进行一次IVA。该方案在第二年被转换为治疗和延长方案。基于眼底自发荧光图像检测到的低自发荧光定量黄斑萎缩的发生率和生长速率。另外，研究了与黄斑萎缩的发展和生长速率有关的可能的背景因素。结果94眼中，有39例（41.5％）患有典型的AMD，55例（58.5％）患有息肉样脉络膜血管病变。基线时有十只眼（10.6％）患有黄斑萎缩。在剩下的84只眼中，有14只（16.7％）在2年时出现了新的黄斑萎缩，萎缩的增长率的平方根为0.52 mm /年。在多变量分析中，发现基线时较差的最佳矫正视力（P = 0.01）和视网膜内积液（P = 0.04）是黄斑萎缩发展的独立预测因子。没有发现与黄斑萎缩的增长率显着相关的因素。结论我们的研究确定了临床环境中新血管AMD的IVA后黄斑萎缩的发生率和增长率。