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Julia Vig, James Talks, Sobha Sivaprasad; Aflibercept outcomes in AMD at 3 years: maintains vision but significant decline in follow up. Invest. Ophthalmol. Vis. Sci. 2017;58(8):411.
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© ARVO (1962-2015); The Authors (2016-present)
Aflibercept was approved for use in the UK for neovascular macular degeneration in July 2013. Treatment requires regular, often long-term follow up, putting strain on patients and services. We aimed to assess outcomes and maintenance of follow up in clinical practice of patients treated for three years by analysing data from a multicentre cohort.
Visual acuity and injection numbers were collected from an electronic medical record on treatment naive patients, who had started treatment 3 years before the data cut off in November 2016. Data was collected from the 17 centres contributing to the UK Aflibercept Users Group.
722 eyes had potential to have data three years from baseline. 246 eyes from 226 patients were still under follow up. Mean age 78.2, 149 were female. In those with 3 years follow up the mean baseline visual acuity was 56.5 letters increasing to 62.8 letters at 12 months (+6.3), 61.3 letters at 24 months (+4.8) and 59.4 letters at 36 months (+2.9, median 3, SD 17.8). Those seeing >70 letters at three years increased from 18.5% to 32%, 26% gained ≥15 letters. Visual loss of ≥15 letters was recorded in 4.5% after the first year, 11.5% at 2 years and 14.7% at 3 years. Mean injection numbers were 6.9 during year 1, 4.1 during year 2, 4 in year 3. For those no longer under follow up the mean change in last vision was -2.1 (median 0, SD 18.7), 19% had lost >15 letters, 15% gained ≥ 15 letters. 21% could see ≥ 70 letters. Follow up percentages at three years varied between centres from 60% to 10%.
Only 34% of eyes were still under follow up at three years reflecting the age related nature of the condition but possibly the difficulties of maintaining the therapy. Patients that were still being monitored showed significant standard deviation with a third of eyes seeing more than 70 letters and one in seven losing 15 or more letters from baseline. Visual acuity of those no longer under follow-up also showed significant variations with 1 in 5 eyes seeing more than 70 letters and another 1 in 5 losing more than 15 letters at last follow-up.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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