Abstract
Purpose :
Studies on long-term outcomes of neovascular age-related macular degeneration (nAMD) eyes on anti-vascular endothelial growth factor (anti-VEGF) injections are limited, especially if there is baseline macular atrophy (MA). This study aims to understand the long-term outcomes of nAMD eyes with baseline MA undergoing anti-VEGF injections.
Methods :
This was a retrospective chart review of nAMD patients receiving at least twice-yearly anti-VEGF injections for nAMD for at least 5 years at Cole Eye Institute from 2012 to 2019. Measurements for sub-RPE illumination (SRI), foveal distance to atrophy (FDA), best visual acuity (BVA), and intraocular pressure (IOP) were collected annually. Eyes were excluded if subretinal fluid precluded reliable measurements or if one-year change in SRI or FDA was greater than 2 standard deviations from the cohort mean. 5-year change in BVA was regressed on combinations of six patient characteristics and baseline measures.
Results :
A total of 232 eyes of 232 patients (83.9±9.0 years, 64% female) with nAMD and at least 5 years of follow-up (mean 6.0 years) with anti-VEGF injections were identified. 76% (n=178) had baseline MA. Baseline BVA was 67.2±13.9 letters for those with MA and 70.8±11.6 without MA (p=0.0971). Both groups experienced an initial non-significant improvement in average BVA before BVA began to decline (Table 1). Average BVA for patients with no MA peaked in year 1 (+3.0 from baseline, p=0.2289) while average BVA in patients with MA peaked in year 2 (+1.3 from baseline, p=0.0947). Additionally, differences in annual BVA change or BVA change from baseline are not statistically significant between groups without and with baseline MA (Table 1, p≥0.1324). Multiple linear regressions found baseline SRI (p=0.0026) and gender (p=0.0401) to be statistically significant regressors for 5-year change in BVA. Age, baseline FDA, baseline BVA, and baseline IOP were not significant regressors.
Conclusions :
In nAMD patients treated with anti-VEGF injections, there was an initial non-significant improvement in vision before decline after two years of treatment. Differences in annual BVA change or BVA change from baseline are not statistically significant between groups without and with baseline MA, but gender and baseline SRI were found to be significant predictors of 5-year BVA change. Larger studies are needed to further explore these trends.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.