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Thomas G. Chu, Homayoun Tabandeh, David S. Boyer, Nik London, Nauman Chaudhry, Veronica Konjara, Phoebe Novack; Intravitreal Anti-VEGF Therapy for Neovascular Age-Related Macular Degeneration (nvAMD) and Poor Vision at Presentation. Invest. Ophthalmol. Vis. Sci. 2011;52(14):110.
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Purpose: Intravitreal anti-VEGF therapy has been demonstrated to be an effective treatment modality for nvAMD. Many clinical studies that established the beneficial effect of intravitreal anti-VEGF therapy did not include the cohort of patients with poor presenting visual acuity. Currently, there is little information regarding the outcomes of anti-VEGF therapy for nvAMD in patients presenting with poor vision. The purpose of the current study is to report on the outcomes of intravitreal anti-VEGF therapy for nvAMD in patients with presenting best corrected visual acuity (BCVA) ≤ 20/400.
Methods: Retrospective case series. Inclusion criteria: patients with previously untreated nvAMD and presenting BCVA ≤20/400. Exclusion criteria: subretinal fibrosis involving central fovea, subfoveal hemorrhage greater than 1 disc area, presence of other ocular pathology reducing vision.
Results: Twenty two eyes of 22 patients, mean age 80.6 (range 70-97) years. BCVA at presentation was 20/400 in 7 (32%), and worse than 20/400 in 15 (68%) patients. Treatment included ranibizumab in 11, bevacizumab in 8, and ranibizumab and bevacizumab in 3 patients. At the last follow-up (mean 16.1 months) BCVA was ≥20/40 in 5 (22%), 20/50-20/100 in 3 (14%), 20/200 in 4 (18%), 20/400 in 6 (27%), and <20/400 in 4 (18%) eyes. Mean number of injections was 7.3 injections.
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