June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Real-World Management of Neovascular Age-Related Macular Degeneration in the US
Author Affiliations & Notes
  • Andrew A Moshfeghi
    Roski Eye Institute, Department of Ophthalmology, University of Southern California, Keck School of Medicine, Los Angeles, California, United States
  • Ehsan Rahimy
    Palo Alto Medical Foundation, Palo Alto, California, United States
  • Nick Boucher
    Vestrum Health, Naperville, Illinois, United States
  • Steven Sherman
    Regeneron Pharmaceuticals Inc, Tarrytown, New York, United States
  • Fabiana Q Silva
    Regeneron Pharmaceuticals Inc, Tarrytown, New York, United States
  • Hadi Moini
    Regeneron Pharmaceuticals Inc, Tarrytown, New York, United States
  • John D Pitcher
    Eye Associates of New Mexico, Albuquerque, New Mexico, United States
  • Footnotes
    Commercial Relationships   Andrew Moshfeghi Allergan, Genentech/Roche, Graybug, Novartis, Ocular Therapeutix, Regeneron Pharmaceuticals, Inc., Pr3vent, Valitor, Waldo, Regenxbio, Code C (Consultant/Contractor), Ocular Therapeutix, Placid0, Pr3vent, Waldo, Code I (Personal Financial Interest); Ehsan Rahimy Allergan through the Fostering Innovative Retina Stars (FIRST) program, Code C (Consultant/Contractor); Nick Boucher Vestrum Health, Code E (Employment); Steven Sherman Regeneron Pharmaceuticals, Inc., Code E (Employment); Fabiana Silva Regeneron Pharmaceuticals, Inc., Code E (Employment); Hadi Moini Regeneron Pharmaceuticals, Inc., Code E (Employment); John Pitcher Genentech (speaker and consultant), Regeneron Pharmaceuticals, Inc. (speaker and consultant), Oyster Point (consultant), Code C (Consultant/Contractor), Alcon (research grant), Code F (Financial Support)
  • Footnotes
    Support  Funding by Regeneron Pharmaceuticals, Inc.
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 3123. doi:
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      Andrew A Moshfeghi, Ehsan Rahimy, Nick Boucher, Steven Sherman, Fabiana Q Silva, Hadi Moini, John D Pitcher; Real-World Management of Neovascular Age-Related Macular Degeneration in the US. Invest. Ophthalmol. Vis. Sci. 2022;63(7):3123.

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

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Purpose : To evaluate the management of neovascular age-related macular degeneration (nAMD), factors that predict receiving treatment, and the relationship between treatment frequency and visual outcomes in routine clinical practice.

Methods : This retrospective analysis assessed electronic medical records from the Vestrum Health Retina Database for treatment-naïve eyes newly diagnosed with nAMD from January 1, 2014 that had ≥1 year of follow-up. Cumulative incidence of eyes receiving treatment was evaluated using the Kaplan–Meier (KM) method, and factors that predicted receiving treatment through one year were evaluated by logistic regression.

Results : Of 90,681 eyes included in the analysis, the percentage of eyes not receiving treatment was 23%, 16%, 15% and 13% at diagnosis and years 1, 2 and 3, respectively. The mean baseline visual acuity (VA) of eyes not treated and treated were 39 and 52 letters, respectively. Higher odds ratio (OR≥1.50, [95% CI]) of receiving treatment was found for eyes with baseline VA 20/40-20/100 vs ≥20/40 (1.52 [1.44, 1.61]); and for eyes with macular edema (3.26 [3.11, 3.42]), subretinal fluid (4.97 [4.75, 5.20]), or sub-retinal pigment epithelium fluid (1.64 [1.56, 1.72]). Lower OR (OR£0.50) for receiving treatment was found for patients with simultaneous bilateral diagnosis (vs. unilateral diagnosis, 0.32 [0.31, 0.34]);and for eyes with baseline VA<20/400 vs. ≥20/40 (0.29 [0.27, 0.30]). When treated within 1 month from diagnosis, eyes gained a mean (SD) of 5 (3) letters from baseline at 6 months, which was maintained at year 1. If treatment initiation was delayed 6 months from diagnosis, eyes gained a mean (SD) of 1 (0) letter at year 1. Mean BCVA change from baseline at year 1 was −1.21, 0.58, 4.31 and 5.6 letters in eyes treated with 1-3, 4-6, 7-9 and >9 injections, respectively. Within the subgroup of eyes that received 7-9 and >9 injections, those with baseline VA<20/400, gained 20.3 and 27.2 letters, respectively.

Conclusions : Almost one quarter of eyes with nAMD did not receive treatment at diagnosis. Simultaneous bilateral nAMD diagnosis and poor baseline VA (<20/400) were primary factors associated with not receiving anti-VEGF treatment. Greater VA gains were observed with prompt treatment and increasing number of injections, with eyes with poor baseline vision (<20/400) gaining a mean of ≥4 lines with ≥7 injections from baseline at year 1.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.


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