July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Development of neovascular age-related macular degeneration in fellow eyes of patients undergoing intravitreal anti-VEGF therapy at a large tertiary ophthalmic hospital
Author Affiliations & Notes
  • Reena Chopra
    NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
  • Siegfried K Wagner
    NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
  • Katrin Fasler
    NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
  • Karsten Ulrich Kortuem
    NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
    University Eye Hospital, Munich, Germany
  • Nikolas Pontikos
    NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
  • Farid Afshar
    NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
  • Thushanthi Ramakrishnan
    NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
  • GABRIELLA CLAIRE PRESTON
    NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
  • Konstantinos Balaskas
    NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
  • Praveen Patel
    NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
  • Adnan Tufail
    NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
  • Pearse Andrew Keane
    NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
  • Footnotes
    Commercial Relationships   Reena Chopra, None; Siegfried Wagner, None; Katrin Fasler, Alfred Vogt Stipendium (F), Schweizerischer Fonds zur Verhütung und Be- kämpfung der Blindheit (F); Karsten Kortuem, Alcon (R), Allergan (R), Bayer (R), Bayer (F), Big Picture (C), Google (C), Novartis (F); Nikolas Pontikos, None; Farid Afshar, None; Thushanthi Ramakrishnan, None; GABRIELLA PRESTON, Bayer (R), City, University of London (E); Konstantinos Balaskas, None; Praveen Patel, Bayer (C), Genentech (C), Heidelberg Engineering (C), Merk (C), Novartis (C), Roche (C), SalutarisMD (C), Thrombogenics NV (C), Thrombogenics NV (F), Topcon (F); Adnan Tufail, Allergan (C), Bayer (C), Genentech (C), Heidelberg Engineering (C), Novartis (F), Novartis (C), Roche (C); Pearse Keane, Allergan (R), Bayer (R), Carl Zeiss Meditec (R), Google (C), Haag-Streit (R), Heidelberg Engineering (R), Novartis (R), Optos (C), Topcon (R)
  • Footnotes
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Investigative Ophthalmology & Visual Science July 2018, Vol.59, 816. doi:
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      Reena Chopra, Siegfried K Wagner, Katrin Fasler, Karsten Ulrich Kortuem, Nikolas Pontikos, Farid Afshar, Thushanthi Ramakrishnan, GABRIELLA CLAIRE PRESTON, Konstantinos Balaskas, Praveen Patel, Adnan Tufail, Pearse Andrew Keane; Development of neovascular age-related macular degeneration in fellow eyes of patients undergoing intravitreal anti-VEGF therapy at a large tertiary ophthalmic hospital. Invest. Ophthalmol. Vis. Sci. 2018;59(9):816.

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

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Abstract

Purpose : Age-related macular degeneration (AMD) is usually a bilateral condition but may not progress at the same pace in both eyes. In this retrospective study, we describe the number of patients undergoing anti-VEGF treatment for neovascular AMD within a tertiary ophthalmic hospital encompassing multiple sites across London, and how many of these patients went on to receive treatment for the same condition in their fellow eye.

Methods : The Moorfields Eye Hospital Electronic Medical Records system was queried between 2007 and 2017 for patients undergoing intravitreal anti-VEGF treatment in one eye, and for those who went on to receive anti-VEGF treatment in their fellow eye. Baseline visual acuity was recorded at the start of treatment for the first and second eye in ETDRS format. Statistical analysis was carried out using SPSS version 23.

Results : Out of 5614 patients, 4372 were receiving anti-VEGF treatment in one eye only during the observation period, and 1242 (22%) patients had received anti-VEGF treatment to both eyes at some stage. Two-hundred and eighty (22.5%) patients presented with bilateral neovascular AMD (interval between injections for the first and second eye <28 days). Involvement of the second eye occurred after a median of 282 days. The mean (SD) difference in ETDRS letters at first injection was +6 (±18) between the eyes, with the first eye having a visual acuity of 55 ETDRS letters and the second eye having a visual acuity of 61 ETDRS letters.

Conclusions : Nearly a quarter of patients had received treatment for bilateral disease, indicating a high risk of developing the disease in fellow eyes. Patients are likely to present with a better baseline visual acuity when their fellow eye is affected. This may be due to closer monitoring and more frequent OCT imaging, and therefore earlier diagnosis, but patients may also be more vigilant of sudden changes in their vision.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

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