Abstract
Purpose: :
To determine visual acuity (VA) and central macular thickness (CMT) in patients with wet age-related macular degeneration (ARMD) receiving bevacizumab and/or ranibizumab with five year (60 month) follow up.
Methods: :
Retrospective chart review of eligible patients with wet ARMD treated with either bevacizumab or ranibizumab on or before 12.1.2005 with follow up of five years or sixty months at a single institution. Snellen VA was recorded for each visit and converted to logMAR. VA at first injection, 6, 12, 18, 24, 30, 36, 42, 48, 54 and 60 month follow up visits were compared. CMT was recorded using optical coherence tomography (OCT) (StratusTM) (Carl Zeiss Meditec, Dublin, CA) at first injection, 12, 24, 36, 48 and 60 month follow up. Values were compared using paired T-test.
Results: :
Eleven eyes had a mean logMAR VA 0.65 (sd +/- 0.27) at initial injection. Mean logMAR VA at six, 12, 18, 24, 30, 36, 42, 48, 54, 60 months was 0.49 (sd +/- 0.12), 0.53 (sd +/- 0.15), 0.66 (sd +/- 0.35), 0.53 (sd +/- 0.37), 0.63 (sd +/- 0.43), 0.58 (sd +/- 0.45), 0.58 (sd +/- 0.29), 0.57 (sd +/- 0.45), 0.56 (sd +/- 0.42), 0.64 (sd +/- 0.45) respectively. There was no statistically significant change in VA at 60 months compared with VA at initial injection (p=0.429). At 60 months, 45.5%, 81.8% and 100% of patients had maintained Snellen VA of 20/40, 20/100 and 20/400. Mean CMT was 328 µm (sd +/- 17) at the initial injection visit. Mean CMT was 212 µm (sd +/- 28) 215 µm (sd +/- 34) 195 µm (sd +/- 26) 197 µm (sd +/- 29) 192 µm (sd +/- 20) at follow up visits 12, 24, 36, 48 and 60 months. The difference in CMT between initial visit and 60 month follow up was statistically significant (p=<.001). Mean follow up was 7.7 weeks (sd +/- 2.2). Patients received intravitreal bevacizumab or ranibizumab at a mean of 47.7% of visits.
Conclusions: :
To date, there are no known studies analyzing VA of patients treated with anti-VEGF agents with 60 month follow up. In this study, VA was maintained at 60 months by giving treatment on an as-needed basis as determined by the provider. This study also showed CMT was significantly decreased at 60 months. Thus, anti-VEGF treatment on an as-needed basis can achieve improvement in macular anatomy and maintain VA over five years.