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John D Pitcher, Andrew A Moshfeghi, Genevieve Lucas, Nick Boucher, Namrata Saroj; Outcomes with Intravitreal Anti-Vascular Endothelial Growth Factor (VEGF) Therapy for Neovascular Age-Related Macular Degeneration (AMD) and Diabetic Macular Edema (DME) in Routine Clinical Practice. Invest. Ophthalmol. Vis. Sci. 2018;59(9):3609.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate outcomes following treatment with intravitreal anti-VEGF agents in routine clinical practice.
This retrospective analysis evaluated data obtained through electronic medical records from patients at multiple clinical sites (Vestrum Health Retina Research Dataset; Naperville, IL) who were newly diagnosed with either neovascular AMD or DME and were initiated on treatment with intravitreal anti-VEGF agents. Patients with less than one year of treatment were excluded. Visual acuity (VA) through 1 year was evaluated in two dosing subgroups that were predetermined: A) ≤6 injections B) ≥7 injections. VA measurements were converted into an approximate ETDRS letter score.
Of the 5609 patients with AMD, 1860 (33%) patients received ≤6 injections, and 3749 (67%) patients received ≥7 injections through 1 year. Corresponding baseline mean VA was 60 and 66 letters, respectively. In both subgroups, 22-24% of the patients presented with VA of ≥20/40; 25% and 15% of patients had VA <20/200 in patients receiving ≤6 and ≥7 injections, respectively. The mean number of injections in patients receiving ≤6 injections was 4.2 with a mean VA gain of 2.0 letters. In patients receiving ≥7 injections, the mean number of injections was 9.0 with a mean VA gain of 6.5 letters. Of the 1730 patients with DME, 926 (54%) patients received ≤6 injections and 804 (46%) patients received ≥7 injections through 1 year. Corresponding baseline mean VA was 72 and 73 letters, respectively. In both subgroups, 31-36% of the patients presented with VA of ≥20/40 and 9-10% of the patients presented with VA of <20/200. The mean number of injections in patients receiving ≤6 injections was 3.5 with a mean VA gain of 2.1 letters. In patients receiving ≥7 injections, the mean number of injections was 9.0 with a mean VA gain of 6.1 letters.
Data from routine clinical practice suggests that average visual gains are higher in patients who received at least 7 injections during the first year of treatment for neovascular AMD or DME compared to those who received fewer injections.
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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