June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
Longer Term Safety Outcomes (4 or More Years) After Initiating Anti-Vascular Endothelial Growth Factor Therapy for Neovascular Age-related Macular Degeneration
Author Affiliations & Notes
  • Erika Tanaka
    Johns Hopkins University School of Medicine, Baltimore, MD
  • Voraporn Chaikitmongkol
    Retina Division, Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD
    Retina Division, Department of Ophthalmology, Chiang Mai University Hospital, Chiang Mai, Thailand
  • Susan Bressler
    Retina Division, Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD
  • Neil Bressler
    Retina Division, Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD
  • Footnotes
    Commercial Relationships Erika Tanaka, None; Voraporn Chaikitmongkol, None; Susan Bressler, Novartis (F), Bausch and Lomb (F), Genentech (F), Thrombogenics (F), Lumenis (F), Notal vision (F), GlaxoSmithKline (C), allergan (F); Neil Bressler, Abbott Medical Optics, inc (F), Alimera Sciences (F), Allergan (F), Bausch &Lomb, Inc (F), Bayer (F), Carl Zeiss Meditec, Inc (F), ForSight Labs, LLC (F), Genentech, Inc (F), Genzyme Corporation (F), Lumenis, Inc (F), Notal VIsion (F), Novartis Pharma AG (F), Pfizer, Inc (F), Regeneron Pharmaceuticals, Inc (F), Roche (F), Thrombogencis (F)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 3168. doi:https://doi.org/
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      Erika Tanaka, Voraporn Chaikitmongkol, Susan Bressler, Neil Bressler; Longer Term Safety Outcomes (4 or More Years) After Initiating Anti-Vascular Endothelial Growth Factor Therapy for Neovascular Age-related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3168. doi: https://doi.org/.

      Download citation file:


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

      ×
  • Supplements
Abstract
 
Purpose
 

To assess longer term safety outcomes (4 or more years) after initiating anti-vascular endothelial growth factor (anti-VEGF) therapy for neovascular age-related macular degeneration (AMD).

 
Methods
 

Retrospective review of clinical data, fundus photos, and fluorescein angiograms from patients with neovascular AMD first treated with intravitreal anti-VEGF therapy during November 2005 to June 2008, and followed for at least 4 years (+/-6 months) at a university-based practice of two retina specialists (SBB, NMB).

 
Results
 

Among 576 neovascular AMD patients treated since anti-VEGF therapy became available, 75 patients (81 eyes) were followed for at least 4 years after initiating treatment (usually ranibizumab, usually in a PRN regimen). 59% were women, mean age was 77 years. Mean follow-up was 4.9 years (range, 3.6-6.6 years). Presenting median visual acuity (VA) with present correction on ETDRS charts was 20/80 (interquartile range (IQR): 20/50, 20/100); at 4 years it was 20/80 (IQR: 20/40, 20/200). 7 eyes (8%) progressed to a predominantly blood lesion within 4 years of treatment initiation (median 2.4 years (IQR: 0.8, 2.8 years) and 2 eyes after 4 years (4.6, 5.8 years). No eye developed geographic atrophy (GA) outside the boundary of a CNV lesion. Among the 8 eyes that presented with GA non-contiguous to the CNV lesion, all had enlargement of the GA. Excluding 8 eyes receiving treatment for intraocular pressure (IOP) at baseline, 6 eyes (8%) required IOP management prior to 4 years and 2 eyes (3%) after 4 years (both at 60 months). 4 patients (5%) had myocardial infarctions (all prior to 4 years), 3 patients (4%) had cerebrovascular accidents (1 prior to 4 years), 3 patients (4%) had transient ischemic attacks (all prior to 4 years), and 1 patient (1%) was hospitalized for gastrointestinal hemorrhage at 60 months.

 
Conclusions
 

Longer term follow-up of patients treated with anti-VEGF drugs for neovascular AMD suggests that instances of predominantly blood lesions continue to occur, while development of GA independent of CNV are uncommon. Frequency of serious local or systemic adverse events of interest seems consistent with expectations in this age group.

 
Keywords: 412 age-related macular degeneration • 748 vascular endothelial growth factor • 453 choroid: neovascularization  
×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×