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Katherine E. Holekamp, Nancy Holekamp; Early Detection of Second Eye CNV in nAMD Leads to Better Visual Acuity and Fewer Injections at Month 12. Invest. Ophthalmol. Vis. Sci. 2020;61(7):3506.
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© ARVO (1962-2015); The Authors (2016-present)
Recent IRIS Registry data disclosed mean baseline visual acuity of 20/85 in the first eye of patients affected with bilateral nAMD and mean baseline visual acuity of 20/79 in the second eye. We hypothesize that if second eye involvement with CNV could be detected earlier, then anti-VEGF treatment would result in better mean final visual acuity and decreased treatment burden at month 12.
We performed a retrospective chart review from the practice of a single retina specialist (NMH) to identify nAMD patients who met the following inclusion criteria: first eye CNV diagnosed and treated, monthly OCT performed OU while treating first eye CNV, and second eye CNV detected during treatment of first eye by the study physician (NMH). Patients were identified from a one-month period, 6/3/19 to 7/3/19, to achieve a representative sample from this physician’s practice. The protocol for all eyes with nAMD was three monthly anti-VEGF injections followed by monthly visits and injections given PRN. The primary endpoints of the study were: mean visual acuity of first eye/second eye at time of CNV diagnosis, mean visual acuity of first eye/second eye at month twelve, and mean number of injections for first eye/second eye at month twelve. Visual acuity was converted to logMAR. Two-tailed Student’s t-test was used for statistical analysis.
Fifty patients met the inclusion criteria. Mean age of the patients was 83.8 years. There were 18 males and 32 females. Mean baseline visual acuity at the time of first eye CNV diagnosis was 20/68. Mean baseline visual acuity at the time of second eye CNV diagnosis was 20/30. Mean visual acuity at month twelve for the first eye CNV cohort was 20/52. Mean visual acuity at month twelve for the second eye CNV cohort was 20/30. Mean number of anti-VEGF injections over twelve months for the first eye CNV cohort and the second eye CNV cohort were 6.26 and 5.74, respectively.
Our results are consistent with our hypothesis that if second eye involvement with CNV is detected earlier, then anti-VEGF treatment results in better mean final visual acuity and decreased treatment burden at month twelve. Second eye CNV/nAMD involvement was detected in this study by monthly OCT on high risk, asymptomatic fellow eyes. With the advent of home OCT, these results present a compelling argument for widespread adoption.
This is a 2020 ARVO Annual Meeting abstract.
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