Abstract
Purpose :
To analyze predictors and develop predictive models of anatomic outcome during ranibizumab as-needed therapy of neovascular age-related macular degeneration (AMD) after 4 years of follow-up.
Methods :
Retrospective case series of 194 patients (253 eyes) treatment-naïve neovascular AMD. Clinical, funduscopic characteristics and OCT were recorded at baseline, 3 months and each year until the end of the follow-up. Baseline angiographic characteristics were also evaluated. R Statistical Software was used for statistical analysis. Main outcome measure was final anatomic macular status.
Results :
Presence of atrophy and greater number of injections were associated with geographic atrophy (GA), whereas male sex, presence of fibrosis, lower vision and lower change in central macular thickness (CMT) at the end of the follow-up were associated with fibrotic scar. Higher probability of preserved macular anatomy was found among patients showing better VA. Contrarily, negative predictors of preserved macular anatomy, were diagnosis in 2009, older age, small area of fibrosis/atrophy, presence of pigment epithelial detachment (PED), atrophy in the fellow eye, and active AMD in the fellow eye. A suitable predictive model to predict the risk of preserved macula vs. GA/scar was developed, and included 4 variables: age, baseline VA, number of injections at 3 months and presence of PED at visit 0.
Conclusions :
A new predictive model for final macular status, based on easily harvested variables in daily clinical routine, is proposed and, if validated, could be a useful tool for individual patient management and clinical research studies.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.