Background To evaluate Detection of Apoptosing Retinal Cells (DARC), Ellipsoid Zone (EZ) loss, EZ-Retinal Pigment Epithelium (RPE) difference, and Hyperreflective Foci (HRF) as predictors of directional macular atrophy (MA) growth in age-related macular degeneration (AMD) using a novel angular plot analysis.Research design and methods Seven eyes with MA from the Phase 2 DARC study (ISRCTN10751859) were identified according to strict criteria. MA growth was measured using sequential follow-up retinal scans. EZ loss, EZ-RPE difference, HRF density, and DARC activity were quantified around the MA center, and angular plots were generated in 1-degree sectors of a full circle centered on the MA lesion. Directional associations with subsequent MA growth were assessed using Spearman's rank correlation.Results Over a mean follow-up of 48.4 months, DARC demonstrated a significantly stronger correlation with future MA growth than EZ loss (p = 0.0191), EZ-RPE difference (p = 0.0267) and HRF density (p = 0.0252).Conclusions In this small preliminary study, DARC appears to provide the strongest, most consistent predictor of directional MA growth. Angular plot analysis provides a robust approach for evaluating progression and supports DARC as a promising biomarker for identifying patients at high risk of MA expansion.
Background: A lack of public availability of trial results may lead to limited understanding of intervention efficacy. This registry-based analysis investigated the proportion of trials lacking public results dissemination, either via registry posting or journal publication, among ClinicalTrials.gov-registered optic neuropathy interventional studies. Research design and methods: In June 2025, ClinicalTrials.gov was searched for interventional optic neuropathy studies. Primary outcome was proportion of trials lacking any public results dissemination across all records. Rates of studies lacking publicly available results across primary endpoint significance and study characteristics were compared. Primary endpoint significance was based on primary endpoint significance (p < 0.05) in journal publication or ClinicalTrials.gov results, or on first reported outcome. Results: Overall, 92/170 trials (n = 5,042 participants) met criteria. Among public studies reporting primary outcomes, 24/35 showed significant results (p = 0.041 vs null 50%; 95% CI, 0.507-0.831). While univariable analyses found that larger enrollment, industry sponsorship, and later study phase were significantly associated with publicly available result status, none of these associations remained statistically significant in multivariable logistic regression (all p > 0.05). Conclusions: In univariable analyses, larger enrollment, later-phase design, and commercial sponsorship associated with greater result dissemination, though associations did not persist in multivariable regression.
