Snyder K, et al. - Experts ascertained if the presence and location of a cilioretinal artery could be related to the risk of late age-related macular degeneration (AMD) in the Age-Related Eye Disease Study (AREDS). Findings suggested an association of the presence of a cilioretinal artery with a lower risk of developing choroidal neovascularization (CNV), but not central geographic atrophy (CGA), thereby, suggesting a possible retinal hemodynamic contribution to the pathogenesis of neovascular AMD.

Methods

• Authors conducted a retrospective analysis of prospective, randomized clinical trial data from 3647 AREDS participants.
• They reviewed the fundus photographs of AREDS participants by 2 masked graders for the presence or absence of a cilioretinal artery and whether any branch extended within 500 μm of the central macula.
• They used multivariate regressions in order to determine the association of the cilioretinal artery and vessel location, adjusted for age, sex, and smoking status, with the prevalence of choroidal neovascularization (CNV) or central geographic atrophy (CGA) and AMD severity score for eyes at randomization and progression at 5 years.
• The main outcomes and measures were the association of cilioretinal artery with prevalence and 5-year incidence of CNV or CGA.

Results

• Findings suggested that among AREDS participants analyzed, mean (SD) age was 69.0 (5.0) years, with 56.3% female, 46.6% former smokers, and 6.9% current smokers.
• As per data, a total of 26.9% of patients had a cilioretinal artery in 1 eye, and 8.4% had the vessel bilaterally.
• Results demonstrated that at randomization, eyes with a cilioretinal artery had a lower prevalence of CNV (5.0% vs 7.6%; OR, 0.66; 95% CI, 0.51-0.85;P=.001) but no difference in CGA (1.1% vs 0.8%; OR, 1.33; 95% CI, 0.76-2.32;P=.31).
• A lower mean (SD) AMD severity score was seen in eyes without late AMD for those with a cilioretinal artery (3.00 [2.35] vs 3.19 [2.40];P=.02).
• Researchers noted that at 5 years, eyes at risk with a cilioretinal artery had lower rates of progression to CNV (4.1% vs 5.5%; OR, 0.75; 95% CI, 0.56-1.00;P=.05) but no difference in developing CGA (2.2% vs 2.7%; OR, 0.83; 95% CI, 0.56-1.23;P=.35) or change in AMD severity score (0.65 [1.55] vs 0.73 [1.70];P=.11).
• In patients with a unilateral cilioretinal artery, a lower prevalence of CNV was seen in the eyes with the vessel than fellow eyes (4.7% vs 7.2%;P=.01).