Outcomes of Persistently Active Neovascular Age-Related Macular Degeneration Treated with VEGF Inhibitors: Observational Study data

Abstract

Purpose: To describe outcomes of eyes with wet AMD subdivided by lesion activity in a large multicenter cohort study.

Methods: Treatment-naïve eyes with sub-foveal choroidal neovascularization receiving anti-VEGF therapy enrolled in the Fight Retinal Blindness! observational study were included. Lesions were graded at each visit as active if there was intraretinal or subretinal fluid attributable to leak from CNV lesion, or fresh hemorrhage. Eyes were divided into 4 groups based the proportion of visits each eye was graded as active during the first 12 months of treatment (Persistent, High, Moderate and Low activity).

Results: 655 eyes were included. Low activity group (n=153) were graded active in 0-26% of visits, moderate activity group (n=154) were graded active during 27-57% of visits, high activity group (n=152) were graded active during 58-99% of visits and eyes in the persistent activity group (n=196) were graded active in 100% of visits. Similar mean visual acuity changes compared with baseline were observed in all 4 groups at 12 months (+6.8, +8.3, +6.2 and +5.5 letters for the Low, Moderate, High and Persistent groups respectively; p<0.001 for each group). The mean number of injections given increased only modestly in groups with more active lesions (7.6, 7.9, 8.4, 8.3 respectively, P=0.015). Proportions of occult and minimally classic lesions were higher in the more active groups (P=0.024).

Conclusions: Persistent activity of neovascular lesions during 12 months after starting intravitreal therapy was not associated with worse visual outcomes in this observational study of AMD.

Keywords: 412 age-related macular degeneration • 462 clinical (human) or epidemiologic studies: outcomes/complications • 748 vascular endothelial growth factor