Abstract
Purpose :
This retrospective, observational clinical study examines the Anti-VEGF treatment outcome in a district ophthalmic centre in North London, UK for the treatment of wet ARMD
Methods :
Between April 2013 and November 2019,Ranibizumab and Aflibercept have been used as first line intravitreal agents in North Middlesex University Hospital (NMUH) for the treatment of wet ARMD based on NICE guidelines. A total of 230 eyes were treated during this period in the ophthalmic unit of NMUH. 114 eyes were treated by Ranibizumab and 116 eyes were treated by Aflibercept. All eyes were analysed retrospectively through an electronic system( Medisoft) for the following outcomes:
Mean VA over time
Mean VA over time 1st and 2nd treated eyes
Mean VA over time by baseline VABetween
Proportion of Eyes achieving defined VA levels
Proportion of eyes with 5, 10 or 15 letters changes
Switchers – Change in VA over time from switching
Switchers – Mean VA over time before and after switching
Change in VA over time against Ranibizumab and Aflibercept Trials
Results :
Total numbers of eyes was 230 with total number of patients being 202. Males 81, (35.2%) and 149 (64.8%) females.
A report summary of the data at month 12: 75 eyes injected, 56.0% (42) ≥5 letters gain, 36.0% (27) eyes ≥10 letters gain and 25.3% (19) eyes achieved ≥15 letters gain.
At 24 months, a total number of 45 eyes injected with 51.1% (23) eyes achieving ≥5 letters gain, 40.0% (18) eyes achieving ≥10 letters gain and 26.7% (12) eyes achieving ≥15 letters gain.
At 36 months, a total number of 34 eyes were injected, 38.2% (13) eyes achieving ≥5 letters gain, 29.4% (10)eyes achieving ≥10 letters gain and 11.8% (4) eyes achieving ≥15 letters gain.
Conclusions :
In real world settings, treatment of wet ARMD with Ranibizumab and Aflibercept compares favourably to the landmark clinical trials with idealistic circumstances.
At month 12, 16 and 22, our study results of Ranibizumab shows slightly better visual gain compared to Anchor and Marina Trials at the same period. However Aflibercept results shows almost identical results to the landmark Trails throughout the course from month zero to month 24 with slightly better gain at month 22 compared to the same period in Anchor and Marina.
The greatest improvement in mean VA was among the group of patients with baseline letter score between 70 to 80 ETDRS, comes 2nd the baseline score between 60 and 70.
This is a 2020 ARVO Annual Meeting abstract.