Abstract
Purpose :
Exudative Age-Related Macular Degeneration (eAMD) is the leading cause of vision loss in the western world. Most of the clinical studies in eAMD include eyes with 20/40 or worse visual acuity (VA). However, a small subset of patients may also present with good VA. Literature lacks knowledge about the clinical characteristics, treatment protocols, and long-term outcomes in this subset. The aim of this study was to describe clinical characteristics and treatment outcomes of anti-VEGF monotherapy in this subset of wet AMD patients with good VA (20/40 or better).
Methods :
This was a retrospective chart review study that included patients who had a diagnosis of naive exudative AMD with good VA presenting between 2011 and 2021. Patient charts were from a single hospital system. Eyes with a history of anti-VEGF injections; less than one-year follow-up; history of vitrectomy, and/or any associated ocular disease were excluded. Clinical data were collected for both the eye of interest and the fellow eye including ocular and systemic history, BCVA, imaging findings, and anti-VEGF therapy details.
Results :
Fifty-one eyes of 49 patients were included in this study per inclusion criteria. Average age at presentation was 75 ± 8.23 years with 33 (64%) female eyes and 18 (36%) male eyes. All eyes were treated as needed after loading-dose. Average LogMAR at baseline was 0.176 ± 0.11 (Snellen’s equivalent 20/30) with a VA at 1 year follow-up of 0.185 ± 0.19 (Snellen’s equivalent 20/31) (p = 0.78). 3 (6%) patients lost more than 3 Snellen lines after one year. Of the 51 eyes analyzed, 11 fellow eyes concurrently had a confirmed diagnosis of wet AMD with an average LogMAR of 0.181 ± 0.27 (Snellen’s equivalent 20/30). An average of 6.14 ± 2.72 injections were administered per patient during the first year of diagnosis with an average maximum treatment-free interval of 3.77 ± 3.03 months
Conclusions :
Eyes with good visual acuity with active wet AMD maintained good visual acuity throughout the first year of anti-VEGF monotherapy with a treatment-free interval of approximately 4 months. Further analyses are underway to assess changes in VA and other parameters for area under the curve (AUC) analysis.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.