July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Vertical metamorphopsia improved in patients treated with Aflibercept for neovascular AMD at eighteen months follow-up.
Author Affiliations & Notes
  • Marion Schroeder
    Ophthalmology, Lund University, Lund, Sweden
  • Monica Loevestam-Adrian
    Ophthalmology, Lund University, Lund, Sweden
  • Footnotes
    Commercial Relationships   Marion Schroeder, Bayer Pharma AG (F); Monica Loevestam-Adrian, Allergan (C), Bayer Pharma AG (F), Bayer Pharma AG (C), Novartis (C)
  • Footnotes
    Support  Bayer Pharma AG
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 2379. doi:
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    • Get Citation

      Marion Schroeder, Monica Loevestam-Adrian; Vertical metamorphopsia improved in patients treated with Aflibercept for neovascular AMD at eighteen months follow-up.. Invest. Ophthalmol. Vis. Sci. 2018;59(9):2379.

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

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Abstract

Purpose : To evaluate the best-corrected visual acuity (VA), near vision acuity (NVA), metamorphopsia, quality of life (QoL) and central retinal thickness (CRT) in patients treated with Aflibercept for neovascular age-related macular degeneration (nAMD).

Methods : This prospective, randomized study included 28 eyes of 28 treatment-naïve patients (mean age 79 ±8 years) with nAMD. We examined VA, NVA, optical coherence tomography (OCT), and quantified metamorphopsia with M-CHARTS as horizontal metamorphopsia (MH) and vertical metamorphposia (MV) prior to intravitreal treatment with Aflibercept, at 6 and 18 months follow-up. We evaluated vision-related QoL with the National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) before and 18 months after the first treatment.

Results : M-CHARTS questionnaire score, the patients subjective metamorphopsia, significantly improved at 6 months (p=0.025) and at 18 months (p=0.019) compared to baseline. The M-CHARTS test showed a trend to decreased MV at 6 months (p=0.057) and a significant decrease at 18 months (p=0.002). At baseline 17.2% of the 28 patients experienced no degree (0°) of MV, 25% 0° MH, respectively. At 6 months 25% perceived 0° MV, 27.6% 0° MH; which still improved by 18 months with 37% 0° MV, and 44.8% 0° MH. NEI-VFQ-25 items that significantly improved were the composite score (p=0.015), general vision (p=0.003), near activities (p<0.001), mental health (p=0.01), and role difficulties (p=0.005).

Confirming earlier studies neither M-CHARTS questionnaire nor test scores correlated with changes of VA or CRT. We showed significant improvement in mean VA from 65 ±13 to 71 ±16 letters (p=0.001) after 6 months, and 72 ±10 letters (p=0.004) at 18 months follow-up. CRT decreased from 300 ±80 μm to 220 ±37 μm (p<0.001) by 6 months, and was stable at 18 months with 218 ±35 μm (p<0.001). The decrease in OCT values correlated well with the improvement of VA and NVA at 6 months (r=-0.63; p<0.001 vs r=0.405; p=0.036), and 18 months (r=-0.778; p<0.001 vs r=0.525; p=0.007), respectively. Patients had received mean 4.7 ±0.5 injections after 6 months, and 10.9 ±1.9 after 18 months.

Conclusions : The subjective metamorphopsia score and MV had significantly decreased by 18 months. VA and NVA outcome correlated well with the decrease of CRT, but not with any M-CHARTS outcome. M-CHARTS scores could be considered an independent parameter.

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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