Baseline factors that are associated with change in visual acuity in intermediate AMD over two years in a multicentre cohort study in Europe- INTERCEPT-AMD Report 2

Abstract Background/Objectives: The aim of this study was to evaluate the change in visual acuity (VA) in participants with intermediate age-related macular degeneration (iAMD) over two years when categorized by the presence or absence of incomplete retinal and retinal pigment atrophy (iRORA) and subretinal drusenoid deposits (SDD). Subjects/Methods: In this multicentre cohort study, participants with iAMD were classified as: i) iAMD with no iRORA or SDD; ii) iAMD with SDD with no iRORA; iii) iAMD with iRORA with no SDD and iv) iAMD with iRORA and SDD. The change in VA over two years in the whole cohort and in each sub-category was analysed using a linear mixed effect model employing an unstructured covariance structure. Associations with age, sex and baseline VA were evaluated. Results 983 eyes from 805 participants were analysed. The mean baseline VA changed from 79.8 (SD 8.1) to 78 (SD 10.1) Early Treatment Diabetic Retinopathy Study (ETDRS) letter score at two years. All sub-categories showed a small decline in VA. The group with both iRORA and SDD experienced a statistically significant decline in VA from baseline across all time points (6,12, 18 and 24 months) and by month 24 a change of -2.72 ETDRS letters (95% CI -4.16, -1.28), P < 0.001 was observed. Increasing age and lower baseline visual acuity were associated with lower VA over two years. Conclusions Eyes with iAMD experience a small mean decline of approximately 2 letters over two years. Overall, these changes may not represent a clinically meaningful difference.