Abstract
Purpose:
To report the impact of anti-vascular endothelial growth therapy on reading performance in patients with neovascular age-related macular degeneration (nAMD) enrolled in a clinical trial.
Methods:
Prospective, multi-centre, double-masked, randomised controlled trial of 131 patients with nAMD in a hospital setting. Patients received intravitreous bevacizumab (n=65) or standard care (n=66) to the study eye with a 6 weekly cycle of assessment. Bevacizumab treatment was 1.25mg/0.05ml given as 3 initial treatments with further retreatment as needed using standardised retreatment criteria and one year (54 week) follow-up. Reading performance was determined during the study using MNREAD charts and was a pre-specified but exploratory analysis.
Results:
At the week 54 examination, bevacizumab treated patients had an overall improvement in reading performance while patients randomised to standard care had a decline in reading performance. Bevacizumab treated patients were more likely to improve at least 0.3 logMAR in reading acuity (RA) than the patients receiving standard care (26 [ 40%] versus 6 [9.1%], P < 0.0001). There was also an improvement in the maximum reading speed (MRS) with 18 bevacizumab treated patients (27.7%) improving by 80 words/minute or more compared to 1 patient (1.5%) receiving standard care (P < 0.0001).
Conclusions:
Bevacizumab improved the chances of a clinically relevant gain in reading performance in the study population. Given the importance of reading as an activity of daily living and as a goal of rehabilitation in visual impairment, the beneficial effects of bevacizumab therapy are expected to have a favourable impact on performance in reading based activities.