September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Adherence to treatment determines 5-year outcome in neovascular AMD in a real-life setting
Author Affiliations & Notes
  • Robert G H Wilke
    KH Dresden - Friedrichstadt, Dresden, Germany
  • Helmut G Sachs
    KH Dresden - Friedrichstadt, Dresden, Germany
  • Footnotes
    Commercial Relationships   Robert Wilke, Novartis Pharma GmbH (R); Helmut Sachs, None
  • Footnotes
    Support  supported with a grant by Novartis Phrama GmbH
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 3362. doi:
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      Robert G H Wilke, Helmut G Sachs; Adherence to treatment determines 5-year outcome in neovascular AMD in a real-life setting. Invest. Ophthalmol. Vis. Sci. 2016;57(12):3362.

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

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Purpose : We were interested in understanding which factors determine relatively poor 5-years outcome of anti-VEGF treatment of AMD in a real-life setting as compared to prospective studies. We investigated if there is a subpopulation in our real-life data that has a significanty better 5-years outcome by stratifying by disease stages, number of injections, access to treatment an adherence to treatment.

Methods : This is a retrospective analysis of 1500 cases of neovascular AMD being treated according to a PRN scheme between 2010 and 2014. Letter scores for a period of up to 5 years have been evaluated as well as number of injection in each year. Visual acuity at baseline served as a marker for disease stage at baseline, the interval between visits as a marker for adherence to therapy. At a certain time access to treatment was greatly facilitated by introducing a general treatment allowance for the public healthcare system. Accordingly, subgroups have been defined as earlier disease stages, higher number of injections, faster access to treatment and adherence to treatment.

Results : In the overall population the initial gain in letter score is reverted by end of year 2. The subgroups with high injections and earlier disease stages have both a significantly better outcome, however by year 3 there is also a loss below baseline. Ease of access to treatment clearly improves the initial gain, where a second upturn in letter score after the initial upload is observed. Only the group with good adherence to treatment, however, continues to have a positive letter score over 5 years.

Conclusions : More than the stage of disease do adherence to treatment and access to treatment determine long term outcome in anti-VEGF treatment in AMD in a PRN setting.

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


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