Abstract
Purpose :
This study assessed best corrected visual acuity (BCVA) and central subfield thickness (CST) outcomes for Limited Early Responders (LER) and Early Responders (ER) at 24 and 36 months and characterized these patients based on demographics, baseline systemic variables and systemic comorbidities.
Methods :
A retrospective chart review of 112 patients that were characterized at 3 months after their first anti-VEGF injections as LER depending on if they met the anatomic criteria [anatomic LER (aLER) = CST reductions ≤ 10%] and/or the visual criteria [visual LER (vLER) = ETDRS letter gains < 5 letter]. All other patients outside of these anatomic/visual criteria were classified as ER (aER/vER). Statistical analyses were performed using Welch's t-test, multivariable linear regression, and multivariable logistic regression.
Results :
BCVA and CST change from baseline to the 24- and 36-month time points were not significant after controlling for differences in baseline. When evaluating from 3 months onwards, BCVA differences between the groups total LER vs ER and vLER vs vER were found to be significant. There was a greater decrease in mean BCVA from 3 months to 36 months in the total ER group compared to the total LER group (-10.73 ETDRS letters vs -0.27, p<0.05). Alternatively, there was a decrease in mean BCVA in the vER cohort while the vLER cohort had a slight increase (-8.58 ETDRS letters vs +0.31, p<0.05). Changes in CST from 3 months onwards were statistically significant between all LER and ER groups with LER groups showing greater reductions beyond 3 months compared to ER counterparts (-65.9μm for total LER vs -6.7μm for total ER, p<0.05). There was a significant negative correlation between smoking pack years in the vLER and LER groups and a significant positive correlation between age at diagnosis and aLER status.
Conclusions :
These results suggest that changes in BCVA and CST across all groups are likely related to baseline levels and thus patients near their maximum BCVA or minimum CST at baseline will likely have a limited response. Once patients reach the 3-month mark, they are unlikely to see much improvement in BCVA but significant improvement in CST if they have a limited response. Such results highlight the value of long-term anti-VEGF treatment and to further explore options that may lead to continued BCVA improvements beyond 3 months.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.