Characteristics of three types of neovascular age-related macular degeneration and treatment strategies of anti-VEGF agents in real-world clinical setting: A multicenter cohort study by J-CREST

Abstract

Purpose : Characteristics of three types of neovascular age-related macular degeneration and treatment strategies of anti-VEGF agents in real-world clinical setting: A multicenter cohort study by J-CREST

Methods : This is a retrospective, multi-centre cohort study. Medical records of 602 patients (320 typical AMD, 247 PCV, and 35 RAP) were retrospectively investigated for age, gender, best corrected visual acuity at baseline and 1 year after the treatment, spectral-domain optical coherence tomography (SD-OCT) findings of intraretinal fluid (IRF), subretinal fluid (SRF), serous pigment epithelial detachment (PED), hard exudates, subretinal hyperreflective material (SHRM), and subretinal hemorrhage (SRH), anti-vascular endothelial growth factor (VEGF) agents, and the number of vitreal injections.

Results : Mean age was 75.3 ± 10.4 years in tAMD group, 74.1 ± 9.7 years in PCV group, and 82.0 ± 6.9 years in RAP, and there was significant difference between 3 groups. Female ratio was also significantly higher in RAP group compared with other 2 groups. Regarding SD-OCT findings, frequencies of SRF and SRH were less, those of IRF and hard exudates were more in RAP group than in tAMD or PCV group. Serous PED was the most in PCV group followed by RAP group and tAMD group. The ratio of aflibercept vs. ranibizumab was 72 : 28 in tAMD group, 69 : 31 in PCV group, and 63 : 37 in RAP group, however there was no significant difference in the number of injections of anti-VEGF agent. Both LogMAR at baseline and 1 year after the initiation of treatment were significantly higher in RAP group (0.64 ± 0.43 and 0.56 ± 0.46) than in tAMD group (0.44 ± 0.48 and 0.37 ± 0.56) and in PCV group (0.43 ± 0.55 and 0.27 ± 0.43), and LogMAR VA was significantly improved by anti-VEGF treatment for 1 year compared with baseline in tAMD group and PCV group but not in RAP group.

Conclusions : Frequencies of individual OCT findings were significantly different between tAMD, PCV, and RAP groups, and ranibizumab was more employed for RAP group. SRF and SRH were less in RAP group, however the visual prognosis was worse.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.