{"doi":"10.1016/j.xops.2025.101028","title":"Longitudinal Study of Macular Preservation and Geographic Atrophy Progression in Age-Related Eye Disease Study 2","abstract":"Purpose:To investigate the natural history of macular tissue preservation in geographic atrophy (GA) by evaluating the relationship between the macular tissue integrity index (MTII) and best-corrected visual acuity (BCVA) over time.Design: Post hoc analysis of Age-Related Eye Disease Study 2 (AREDS2), a multi-center, randomized clinical trial.Participants: Participants from the AREDS2 fundus autofluorescence ancillary study with nonsubfoveal GA.Methods: Areas of GA were segmented by a deep learning algorithm and verified by expert graders.Macular tissue integrity index was defined as the percentage of the macula without GA within the central 1-mm and 3-mm circles.Baseline associations with BCVA were assessed, and longitudinal analyses evaluated GA progression, MTII loss, and BCVA decline over time.Main Outcome Measures: Geographic atrophy area, MTII, and BCVA.Results: Two hundred forty-three eyes (194 participants) were included.The median follow-up was 2 years.At baseline, the mean GA area was 1.8 mm 2 (standard deviation 2.7), and the growth rate was 1.3 mm 2 /year.Baseline mean MTII in the 1-mm zone was 95.2% (standard deviation 9.1) with a decrease of 5.4%/year, and 87.3% (standard deviation 14.5) in the 3-mm zone with a decrease of 6.7%/year.Baseline mean BCVA was 76.4 letters (standard deviation 11.8; Snellen equivalent 20/30) with a 1.5-letter loss/year.Baseline MTII showed significant correlations with BCVA (1 mm: r = 0.17, P = 0.01; 3 mm: r = 0.14, P = 0.03), while GA area was not significantly associated with BCVA (r = -0.02,P = 0.71).Multivariable analysis showed that MTII in the 1-mm and 3-mm zones was associated with visual loss (both P < 0.0001).When eyes were stratified by MTII decline rate (stable/moderate/rapid), those in the rapid group showed numerically greater vision loss and GA growth.Conclusions: This study characterizes the natural history of central macular preservation in GA using MTII.Results show moderate but significant associations with BCVA cross-sectionally and longitudinally.These findings suggest that MTII may offer complementary functional context for evaluating disease progression in GA, warranting further validation in clinical trial settings.","journal":"Ophthalmology Science","year":2025,"id":549623,"datarank":0.10397207708399181,"base_score":0.6931471805599453,"endowment":0.6931471805599453,"self_citation_contribution":0.10397207708399181,"citation_network_contribution":0.0,"self_endowment_contribution":0.10397207708399181,"citer_contribution":0.0,"corpus_percentile":22.178386323199504,"corpus_rank":9377,"citation_count":1,"citer_count":1,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":true,"is_dataset_confidence":0.8114,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1443839,"name":"Thomas F. Saunders","orcid":"0009-0008-6773-1189","position":1,"is_corresponding":false},{"id":536776,"name":"Karl G. Csaky","orcid":"0000-0002-5466-8829","position":2,"is_corresponding":false},{"id":254973,"name":"Elvira Agrón","orcid":"0000-0002-2829-4042","position":3,"is_corresponding":false},{"id":1444376,"name":"Tiarnán D.L. Keenan","orcid":null,"position":4,"is_corresponding":false},{"id":54567,"name":"Emily Y. Chew","orcid":"0000-0003-0999-9802","position":5,"is_corresponding":false},{"id":427325,"name":"Barbara A. Blodi","orcid":null,"position":6,"is_corresponding":false},{"id":286058,"name":"Amitha Domalpally","orcid":"0000-0002-8145-9619","position":7,"is_corresponding":false},{"id":1443838,"name":"Sairi Zhang","orcid":"0009-0008-7091-7144","position":0,"is_corresponding":true}],"reference_count":23,"raw_metadata":null,"created_at":"2026-07-19T02:54:07.823422Z","pmid":"41626422","pmcid":"PMC12859250","fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}