July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Long term outcomes of anti-vascular endothelial growth factor therapy in neovascular age related macular degeneration
Author Affiliations & Notes
  • Muhammad Raza Cheema
    Ophthalmology, Royal Victoria Infirmary, UK, Newcastle Upon Tyne, United Kingdom
  • Joanna Dacosta
    Ophthalmology, Royal Victoria Infirmary, UK, Newcastle Upon Tyne, United Kingdom
  • Devangna Bhatia
    Ophthalmology, Royal Victoria Infirmary, UK, Newcastle Upon Tyne, United Kingdom
  • James S Talks
    Ophthalmology, Royal Victoria Infirmary, UK, Newcastle Upon Tyne, United Kingdom
  • Footnotes
    Commercial Relationships   Muhammad Cheema, None; Joanna Dacosta, None; Devangna Bhatia, None; James Talks, Allergan (C), Bayer (C), Bayer (R), Novartis (C)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 1192. doi:
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      Muhammad Raza Cheema, Joanna Dacosta, Devangna Bhatia, James S Talks; Long term outcomes of anti-vascular endothelial growth factor therapy in neovascular age related macular degeneration. Invest. Ophthalmol. Vis. Sci. 2019;60(9):1192.

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

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Abstract

Purpose : Neovascular age related macular degeneration (nAMD) is a chronic progressive condition. This study evaluated the long-term outcomes in terms of visual acuity and disease status 10 years after initiation of anti-vascular endothelial growth factor (anti-VEGF) therapy in nAMD

Methods : Retrospective review of electronic medical records of a consecutive series of patients treated with anti-VEGF therapy for nAMD over a 10 year period from 2008 to 2018. Age, lens status, number of injections, numbers lost to follow up, baseline BCVA, and BCVA at 3, 5, 7 and 10 year follow up time points were recorded. A paired t-test was used to compare mean vision at baseline and at each timepoint.

Results : Mean age at baseline was 76 years. 65% eyes were phakic. At 10 years follow up, 55/111 (49%) eyes were receiving anti-VEGF therapy, 28/110 (25%) patients were deceased, 36/111 (32%) eyes had a dry macula with scarring or atrophy, and 6 patients had been discharged. Out of 49% eyes receiving anti-VEGF therapy after 10 years, 11/55 (20%) had BCVA > 70 letters, 21/55 (38%) had BCVA between 50 – 69 letters after 10 years. Of the whole group, 2/111 eyes did not have BCVA recorded at baseline, 34/109 (31%) eyes had vision of ≥ 70 letters at baseline, 31/105 (30%) at 7 years and 11/71(15%) at 10 years. 54/109 (50%) eyes had vision 50-69 letters at baseline, 31/105(30%) at 7 years and 27/71(38%) at 10 years. 16/109 (15%) eyes had vision of 35-49 letters at baseline, 28/105 (27%) at 7 years and 14/71 (20%) at 10 years. 5/109 (5%) eyes had vision < 35 letters at baseline, 15/105 (14%) at 7 years and 19/71 (27%) at 10 years. Mean change in BCVA at 3 years was -0.76 letters (p =0.48), at 5 years was -2.42 letters (p=0.08), at 7 years was -6.50 letters (p=0.002), and at 10 years was -13.03 letters (p=0.001). Mean number of injections over 10 years was 34.7

Conclusions : nAMD is a chronic disease, 49% of eyes were receiving anti-VEGF injections after 10 years. Mean vision was maintained at 5 years follow up. A significant loss of mean vision occurred by 7 years. Patients with baseline vision ≥ 70 letters, maintained vision for 7 years. This suggests that anti-VEGF therapy delays the natural progression of visual loss associated with nAMD. Long term continuous treatment is required and this has implications for management planning

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

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