June 2020
Volume 61, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2020
Anti-VEGF Treatment Outcomes in Exudative Age-Related Macular Degeneration with Five Years or Longer Treatment in Routine Clinical Practice
Author Affiliations & Notes
  • Grant L Hom
    Case Western Reserve University School of Medicine, Cleveland, Ohio, United States
  • Mark T Bui
    Case Western Reserve University School of Medicine, Cleveland, Ohio, United States
  • Andrew Xie Chen
    Case Western Reserve University School of Medicine, Cleveland, Ohio, United States
    Center for Ophthalmic Bioinformatics, Cleveland Clinic Cole Eye Institute, Cleveland, Ohio, United States
  • Thais Conti
    Center for Ophthalmic Bioinformatics, Cleveland Clinic Cole Eye Institute, Cleveland, Ohio, United States
  • Tyler E Greenlee
    Center for Ophthalmic Bioinformatics, Cleveland Clinic Cole Eye Institute, Cleveland, Ohio, United States
  • Rishi P Singh
    Center for Ophthalmic Bioinformatics, Cleveland Clinic Cole Eye Institute, Cleveland, Ohio, United States
  • Footnotes
    Commercial Relationships   Grant Hom, None; Mark Bui, None; Andrew Chen, None; Thais Conti, None; Tyler Greenlee, None; Rishi Singh, Alcon/Novartis (C), Apellis (R), Bausch + Lomb (C), Genentech/Roche (C), Graybug (R), Ophthea (C), Regeneron Pharmaceuticals (C), Zeiss (C)
  • Footnotes
    Support  Unrestricted Grant Award from Research to Prevent Blindness to the Department of Ophthalmology at Cole Eye Institute (RPB1508DM)
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 4208. doi:
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      Grant L Hom, Mark T Bui, Andrew Xie Chen, Thais Conti, Tyler E Greenlee, Rishi P Singh; Anti-VEGF Treatment Outcomes in Exudative Age-Related Macular Degeneration with Five Years or Longer Treatment in Routine Clinical Practice. Invest. Ophthalmol. Vis. Sci. 2020;61(7):4208.

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

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Abstract

Purpose : Based on numerous clinical trials, anti-vascular endothelial growth factor (anti-VEGF) therapies have demonstrated improved vision outcomes in patients with neovascular age-related macular degeneration (nAMD) for at least 2-3 years. However, published literature does not clearly establish outcomes of patients who have received anti-VEGF for at least 5 years. This study aims to elucidate vision outcomes for long-term anti-VEGF patients in routine clinical practice.

Methods : An IRB approved retrospective chart review at a single institution was performed. A single eye of patients above the age of 18 receiving anti-VEGF injections for nAMD at least five years apart were included in the study. Variables such as visual acuity (VA) differences, central subfield thickness (CST) differences, injection numbers, and appointment numbers are reported in 1-year intervals. Maintaining vision is defined as losing less than 10 ETDRS letters or better from baseline.

Results : 64 patients were included in the study with 43 (67.2%) being female. The average age upon treatment initiation was 77.2±10.0 years with a baseline visual acuity of 66.5±12.8 ETDRS letters. The average length of treatment was 6.8±0.8 years. At 5 years (n=64), the average change in VA was -1.0±16.4 ETDRS (p=0.63) (Figure 1) with an average CST change of -54.5±71.9 μm (p<0.01), an average of 38.8±11.9 appointments, 25.0±12.3 injections, and 47 patients (73.4%) maintaining vision. At 6 years (n=52), the average change in VA was -3.9±19.8 ETDRS (p=0.16) with an average CST change of -63.4±71.1 μm (p<0.01), an average of 46.4±14.2 appointment, 30.2±14.7 injections, and 37 (71.11%) maintaining vision. At 7 years (n=32), the average change in VA was -7.9±20.2 ETDRS (p=0.03) with an average CST change of -53.8±86.7 μm (p<0.01), an average of 52.8±13.4 appointments, 32.6±15.3 injections, and 21 (65.6%) maintaining vision.

Conclusions : These results suggest that many patients who receive anti-VEGF injections for 5-7 years in a routine clinical practice for nAMD will experience a notable decrease in central subfield thickness and a mild decrease in visual acuity over the long-term.

This is a 2020 ARVO Annual Meeting abstract.

 

Figure 1: Visual Acuity Changes in ETDRS from Baseline for Patients Receiving Anti-VEGF

Figure 1: Visual Acuity Changes in ETDRS from Baseline for Patients Receiving Anti-VEGF

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