September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Long-term Outcomes of Neovascular Age-related Macular Degeneration Treated with As Needed Anti-Vascular Endothelial Growth Factor Agents
Author Affiliations & Notes
  • Qisheng You
    Jacobs Retina Center, Shiley Eye Institute, University of California San Diego, San Diego, California, United States
    Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
  • Nadia Mendoza
    Jacobs Retina Center, Shiley Eye Institute, University of California San Diego, San Diego, California, United States
  • Mark Espina
    Jacobs Retina Center, Shiley Eye Institute, University of California San Diego, San Diego, California, United States
  • Mostafa Alam
    Jacobs Retina Center, Shiley Eye Institute, University of California San Diego, San Diego, California, United States
  • Raouf Gaber
    Jacobs Retina Center, Shiley Eye Institute, University of California San Diego, San Diego, California, United States
  • Ilkay Kilic
    Jacobs Retina Center, Shiley Eye Institute, University of California San Diego, San Diego, California, United States
  • William R Freeman
    Jacobs Retina Center, Shiley Eye Institute, University of California San Diego, San Diego, California, United States
  • Footnotes
    Commercial Relationships   Qisheng You, None; Nadia Mendoza, None; Mark Espina, None; Mostafa Alam, None; Raouf Gaber, None; Ilkay Kilic, None; William Freeman, None
  • Footnotes
    Support  Supported in part by UCSD Vision Research Center Core Grant P30EY022589, an unrestricted grant from Research to Prevent Blindness, NY (WRF) and National Natural Science Foundation of China (No. 81400422) (QSY)
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 2670. doi:
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      Qisheng You, Nadia Mendoza, Mark Espina, Mostafa Alam, Raouf Gaber, Ilkay Kilic, William R Freeman; Long-term Outcomes of Neovascular Age-related Macular Degeneration Treated with As Needed Anti-Vascular Endothelial Growth Factor Agents. Invest. Ophthalmol. Vis. Sci. 2016;57(12):2670.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Although clinical trials showed that anti-VEGF therapy have greatly improved the visual prognosis of neovascular age-related macular degeneration (wet AMD), most trials are limited to observations over 1 to 2 years. No studies have evaluated patients receiving PRN dosing over time greater than five years. The aim of current study was to present the 5-10 year visual outcomes in wet AMD eyes treated with PRN anti-VEGF agents.

Methods : This single center retrospective study included 34 eyes of 33 patients with neovascular AMD patients receiving PRN intravitreal anti-VEGF treatment and consecutively followed-up for 5-10 years. Eyes with other macular diseases or received any other forms of treatments such as laser, photodynamic therapy, vitrectomy or intravitreal steroids were excluded. A standardized optical coherence tomography and fluorescein angiography guided PRN protocol was followed. Visual acuity was measured with ETDRS charts and recorded at baseline and at each follow-up examination.

Results : The mean follow-up time was 6.3±1.3years (range 5-10 years). The mean number of intravitreal injections was 23.0±13.0 (range 4-52) during the follow-up period. The median visual acuity improved from 65 letters (Snellen 20/50) at baseline to 70 letters (20/40) at the final visit. 83.9% of the study eyes maintained or improved vision during the follow-up period. At the final visit, 52.9% of eyes were 20/40 or better, 32.4% between 20/40 and 20/200 and 14% below 20/200. Better baseline visual acuity was significantly associated with a good visual outcome at the final visit (P<0.001). More recurrences were associated with more vision loss with eyes with 4 or more recurrences having a loss of 15.1 letters versus a loss of 0.3 letters in eyes with 3 or fewer recurrences (P=0.009), which remained significant (P=0.03) after controlling follow-up period.

Conclusions : Good long-term visual outcomes were achieved in eyes with AMD treated with PRN intravitreal anti-VEGF treatments for up to ten years using a standardized protocol and careful imaging. Good baseline visual acuity, and fewer recurrences predicted a better visual outcome at the final visit.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

 

Annual injection frequency for wet AMD treated with PRN anti-VEGF therapy.

Annual injection frequency for wet AMD treated with PRN anti-VEGF therapy.

 

Mean visual acuity (ETDRS letters) change during the follow-up in eyes with wet AMD treated with PRN anti-VEGF therapy.

Mean visual acuity (ETDRS letters) change during the follow-up in eyes with wet AMD treated with PRN anti-VEGF therapy.

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