Abstract
Purpose:
To examine the impact of switching intravitreal anti vascular endothelial growth factor (VEGF) therapy on patient- reported visual function using the National Eye Institute 25-item Visual Function Questionnaire (VFQ 25) in patients with neovascular age related macular degeneration.
Methods:
This is an IRB approved, prospective cohort study of twenty eyes of eighteen patients who switched therapy from prior alternative VEGF inhibitors (including Pegaptanib, Bevacizumab and/or Ranibizumab) to Aflibercept, between February 2012 and December 2012. All patients were evaluated and treated by one of three retina specialists at our institution. Each patient was asked to complete the NEI VFQ25 at the time of switching therapy, and then at intervals of one month, three months, six months, and one year from the time of cross over to Aflibercept.
Results:
Eleven of eighteen patients were male. Mean patient age was 83.1 years. From baseline to one year following switchover, patients reported greater improvements in general vision, distance activities, social function, mental health, dependency on others, and peripheral vision. Substantial differences were especially noticed from baseline to one month following change in treatment. Statistical significance was achieved for scores in general vision from baseline to three months (p = 0.05) and for scores in mental health from three months to six months (p = 0.01).
Conclusions:
Since it gained FDA approval in 2011 for neovascular ARMD, Aflibercept has expanded the treatment options for this debilitating condition. Our findings suggest that in patients who have switched over to this therapy from previous alternative VEGF inhibitors, there is a trend towards improvement in several aspects of quality of life as assessed by the VFQ 25. While several studies have analyzed the impact of Aflibercept on objectively measured outcomes, such as visual acuity and macular thickness, our study is unique in its assessment of a patient’s disease burden in terms of more subjective outcomes, including social and mental health.
Keywords: 412 age-related macular degeneration •
669 quality of life