READING SPEED IN MACULAR TELANGIECTASIA TYPE 2: AN ANALYSIS OF SHAM PATIENTS IN THE REVAKINAGENE TARORETCEL-LWEY (NT-501) PHASE 3 TRIALS

PURPOSE: To evaluate the relationship between best-corrected visual acuity (BCVA) and reading speed in the sham-treated cohorts from two Phase 3 clinical trials of revakinagene taroretcel-lwey for macular telangiectasia type 2 (MacTel) and to determine whether reading speed captures functional decline not reflected by changes in BCVA. METHODS: This secondary analysis evaluated reading speed (words per minute [wpm] per eye using the International Reading Speed Test) and BCVA (Early Treatment Diabetic Retinopathy Study letters) over 24 months. Associations between BCVA loss and reading speed decline were examined using multiple linear regression. Analysis of covariance (ANCOVA) assessed the effect of eye laterality on reading speed, controlling for baseline factors. RESULTS: Of 111 enrolled sham-treated eyes, 104 had complete data for analysis. For every 1-letter loss of BCVA, the reading speed decreased by 2.1 wpm (P < 0.0001). Sixty-eight eyes maintained stable BCVA (change of <5 letters) but experienced a statistically significant reading speed decline of 19.4 wpm over 24 months (P < 0.0001). An ANCOVA controlling for baseline factors revealed that left eyes were predicted to read approximately 18.5 wpm slower than right eyes at Month 24. CONCLUSION: These findings suggest that BCVA may incompletely capture progressive functional vision loss in MacTel, whereas reading speed detected decline even when BCVA remained stable. Given its sensitivity and clinical relevance, reading speed may provide a meaningful endpoint for assessing MacTel progression and therapeutic efficacy and may also help clinicians quantify functional vision loss in routine practice.