April 2010
Volume 51, Issue 13
ARVO Annual Meeting Abstract  |   April 2010
Response to Intravitreal Anti-VEGF Therapy in Individuals With Advanced Exudative Age-Related Macular Degeneration
Author Affiliations & Notes
  • J. R. Jackson
    Univ of Iowa College of Medicine, Iowa City, Iowa
  • G. S. Hageman
    Ophth. & Visual Sciences, Univ of Utah Moran Eye Center, Salt Lake City, Utah
    Ophth. & Visual Sciences, Univ of Iowa Hospitals & Clinics, Iowa City, Iowa
  • D. D. Saggau
    Wolfe Eye Clinic, West Des Moines, Iowa
  • C. H. Barnes
    Wolfe Eye Clinic, Cedar Rapids, Iowa
  • R. J. Rothman
    Retina & Vitreous Consultants, St. Louis, Missouri
  • R. M. Tarantola
    Ophth. & Visual Sciences, Univ of Iowa Hospitals & Clinics, Iowa City, Iowa
  • K. M. Gehrs
    Ophth. & Visual Sciences, Univ of Iowa Hospitals & Clinics, Iowa City, Iowa
    Center for Retina and Macular Disease, Winter Haven, Florida
  • Footnotes
    Commercial Relationships  J.R. Jackson, None; G.S. Hageman, Optherion, Inc., F; Pfizer Ophthalmics, C; OccuLogix, C; Allergan, C; Optherion, Inc., P; D.D. Saggau, Genentech, F; C.H. Barnes, Eyetech, F; R.J. Rothman, None; R.M. Tarantola, None; K.M. Gehrs, Optherion, Inc., F; Genentech, F; Bausch & Lomb, C; Alcon, C; Eli Lilly, C; Novartis, C.
  • Footnotes
    Support  NIH Grant R24 EY017404 (GSH), Research to Prevent Blindness, Iowa CCOM Summer Research Fellowship (JRJ)
Investigative Ophthalmology & Visual Science April 2010, Vol.51, 920. doi:
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      J. R. Jackson, G. S. Hageman, D. D. Saggau, C. H. Barnes, R. J. Rothman, R. M. Tarantola, K. M. Gehrs; Response to Intravitreal Anti-VEGF Therapy in Individuals With Advanced Exudative Age-Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2010;51(13):920.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose: : To evaluate the visual benefit of anti-vascular endothelial growth factor (VEGF) treatment of advanced stage exudative age-related macular degeneration (AMD) with disciform scarring and/or visual acuity (VA) less than or equal to 1.0 LogMAR (20/200). Randomized prospective clinical trials of anti-VEGF therapy for exudative AMD typically have excluded subjects with disciform scarring and/or VA less than 1.0 LogMAR at initial presentation. Yet clinicians often encounter patients with this clinical presentation, and because there are no recommendations from randomized trials with these inclusion criteria, the decision to treat or observe such eyes is based on anecdotal experience and/or physician and patient preference. We sought to determine in a retrospective analysis whether anti-VEGF treatment in the setting of advanced AMD with poor visual acuity yielded any visual benefit when compared to observation.

Methods: : Patients were recruited from three vitreoretinal practices. Study patients’ eyes were considered independently as intervention was individualized to each eye. Eyes were included which had disciform scarring or VA less than or equal to 1.0 LogMAR at initial presentation. Each eye was followed for a minimum of 12 months, and Snellen VA was measured at each follow-up visit. VA was then converted to LogMAR to eliminate variation among Snellen charts. LogMAR VA at initial presentation and at 12 months follow-up for the control group of 98 untreated eyes and the treatment group of 30 eyes treated with intravitreal anti-VEGF injections were compared by Wilcoxon rank sum test.

Results: : Initial VA was not significantly different between the control (1.3985 LogMAR) and treatment (1.1573 LogMAR, p=0.66) groups. VA at 12 months for the treatment group (0.7401 LogMAR) was significantly improved over the control group (1.3742 LogMAR, p=0.0008). This corresponds to an improvement of roughly four lines of vision on a standard Snellen chart for the treatment group, while VA for the control group remained static.

Conclusions: : Intravitreal anti-VEGF therapy is effective in significantly increasing VA in eyes with advanced stage exudative AMD as compared to observation alone. Clinicians are encouraged to consider this when making treatment decisions for those eyes presenting with disciform scarring or VA less than 20/200 at initial presentation.

Keywords: age-related macular degeneration • vascular endothelial growth factor • clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials 

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