Abstract
Purpose :
This analysis assessed the impact of duration of exposure to residual intraretinal fluid (IRF) on visual function outcomes in eyes with neovascular age-related macular degeneration (nAMD) treated with anti-VEGFs in the VIEW 1 and 2 trials.
Methods :
This post hoc analysis included patients that received either ranibizumab 0.5 mg q4 weeks (Rq4) or intravitreal aflibercept injection 2 mg q4 weeks (IAI 2q4) or q8 weeks after 3 monthly doses (IAI 2q8) in VIEW 1 and 2. Duration of IRF from baseline through week 52 was evaluated as quartiles in both pooled treatment groups (Q1: ≤2 weeks, n=581; Q2: 3–≤8 weeks, n=411; Q3: 9–≤18 weeks, n=389; Q4: >18 weeks, n=423) and within each treatment group (Rq4, n=588; IAI 2q4, n=612; IAI 2q8, n=604). Visual function outcomes assessed included best corrected visual acuity (BCVA) and Visual Function Questionnaire 25 (VFQ-25) near activities and driving subscale scores.
Results :
In the pooled analysis of treatment groups, mean BCVA gains from baseline at week 52 for Q1–Q4 were 10.9, 10.1, 9.4, and 6.6 (P<0.0001, Q4 vs Q1) letters, respectively. The corresponding proportions of patients with a ≥5 letters gain at week 52 were 71.4%, 72.0%, 72.6%, and 59.9% (P<0.05, Q4 vs Q1), and for those with a ≥5 letters loss at week 52 were 10.0%, 9.7%, 11.2%, and 16.5% (P<0.05, Q4 vs Q1), respectively. The mean change from baseline in the VFQ-25 near activities subscale score in Q1–Q4, respectively, were 9.7, 8.3, 7.2, and 5.3 (P<0.001, Q4 vs Q1) points, and for the driving subscale score were 3.0, 1.6, 2.4, and –2.4 (P<0.01, Q4 vs Q1) points. In the quartile analysis within each treatment group, the mean BCVA gains for Q1–Q4 were 11.0, 11.1, 9.3, and 5.8 (P<0.05, Q4 vs Q1) letters for Rq4; 10.7, 9.7, 9.2, and 7.7 letters for IAI 2q4; and 11.3, 11.2, 8.6, and 6.3 (P<0.05, Q4 vs Q1) letters for IAI 2q8, respectively.
Conclusions :
In this analysis of patients treated with intravitreal aflibercept and ranibizumab in VIEW 1 and 2, longer duration of exposure to residual IRF was associated with lower visual acuity gain and worse vision-related quality of life outcomes.
This is a 2021 ARVO Annual Meeting abstract.