Abstract
Purpose :
Few studies have compared the outcomes of eyes with neovascular age-related macular degeneration (nAMD) treated with aflibercept, bevacizumab, and/or ranibizumab in a single patient population.
Methods :
Retrospective cohort study (10/2006 to 2/2019) of eyes with nAMD treated with three monthly injections of anti-VEGF, then transitioned to treat-and-extend. Primary outcome was change in best-corrected visual acuity (BCVA). Secondary outcomes included change in drusen load and development of geographic atrophy. Unpaired t-tests, ANCOVA, and linear regression were computed with SAS 9.4.
Results :
145 eyes received an average of 13 anti-VEGF injections (range 1 – 26 injections) over 24 months. Follow-up: 71 eyes (49.0%) aflibercept, 27 eyes (18.6%) bevacizumab, and 47 eyes (32.4%) ranibizumab. Baseline and 24-month BCVA were unchanged at 0.63 logMAR. Stratified by number of injections, eyes treated with ≥11 injections (more than once every 3 months) had significantly better 24-month BCVA than eyes treated with ≤ 10 injections (0.47 logMAR vs. 0.77 logMAR, p < 0.01). At 24 months, eyes with ≥11 injections also had significantly less GA area and growth rate. There was no significant difference in visual acuity or geographic atrophy based on choice of anti-VEGF treatment. Eyes treated with aflibercept had significantly lower drusen volume at 24 months than eyes treated with ranibizumab (0.18 mm3 vs. 0.49 mm3, p = 0.02).
Conclusions :
On a treat-and-extend regimen, treatment of nAMD with aflibercept, bevacizumab or ranibizumab demonstrated comparable BCVA at 24 months. More frequent injections of anti-VEGF led to significantly improved visual acuity and slower growth of GA.
This is a 2020 ARVO Annual Meeting abstract.