Long-term outcomes of intravitreal anti-VEGF therapy in eyes with both neovascular age-related macular degeneration and diabetic retinopathy.

Abstract

Purpose : To investigate the long-term outcomes of intravitreal anti-VEGF therapy in eyes with both neovascular age-related macular degeneration (AMD) and diabetic retinopathy (DR).

Methods : Patients from 4 high-volume referral centers who presented with concomitant neovascular AMD and DR, and received intravitreal anti-VEGF therapy, were retrospectively enrolled into this study. Data retrieved from medical records and multi-modal imaging were analyzed.

Results : Forty-one eyes of 38 patients (21 male, 17 female; mean age 78±8 years) were enrolled. Median follow up was 28±19 [12-72] months. During follow-up, a mean of 9.2±7.4 intravitreal anti-VEGF injections per eye were administrated: 13 eyes (32%) received a mean of 5.7±3.7injections of bevacizumab, 35 eyes (85%) received a mean of 6.6±4.3 injections of ranibizumab, 1 eye (2%) received 7 injections of pegaptanib, and 8 eyes (20%) received a mean of 6.1±5.5 injections of aflibercept. Best-corrected visual acuity was 0.5±0.3 LogMAR at baseline; it improved significatively at 1 year (0.3±0.3 LogMAR; p=0.02) and returned to baseline values at last follow up visit (0.6±0.4 LogMAR; p=0.26). Mean central macular thickness (CMT) significantly decreased from 408±150 μm at baseline to 328±104 μm at one year (p=0.021) and to 335±127 μm at last follow up visit (p=0.032). No adverse events were recorded. The baseline severity of DR (International Clinical Diabetic Retinopathy Disease Severity Scale) was graded as mild non proliferative diabetic retinopathy (NPDR) in 21 (51%) eyes, moderate NPDR in 15 (36%) eyes, severe NPDR in 3 (7%) eyes, and proliferative diabetic retinopathy (PDR), but inactive due to panretinal photocoagulation, in 2 (5%) eyes; at last follow-up visit, 1 eye graded as moderate NPDR at baseline improved to mild, 1 eye graded as severe NPDR at baseline improved to mild and one eye graded as severe NPDR was inactivated due to photocoagulation

Conclusions : Long-term analysis of intravitreal anti-VEGF therapy for eyes with both neovascular AMD and DR showed stabilization of BCVA and a reduction in CMT, along with stable or improved DR throughout follow-up.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.