Abstract
Purpose :
Anti-Vascular Endothelial Growth Factor (Anti-VEGF) medications reduce and prevent recurrence of fluid in the retina observed in Neovascular Age-Related Macular Degeneration (NAMD). Faricimab-svoa (Q) is an Anti-VEGF drug designed to reduce Central Subfield Thickness (CST) and improve Visual Acuity (VA) with a lower injection burden. However, Q may have varying efficacy in Pars-Plana Vitrectomy (PPV) eyes due to absent vitreous or anatomical changes from surgical conditions.
Methods :
Records from patients receiving Q were obtained from the database of a single-specialty retina practice, Retina Associates of Cleveland, and parsed for disqualifying factors, primarily multi-drug therapy in the study eye. The baseline VA and CST (via Optical Coherence Tomography) were taken at the time of the first post-PPV Q injection, and at the time of subsequent visits to a maximum of four post-PPV injections. A control group who received at least four Q injections for NAMD and had never received PPV were recruited. The vision was converted from Snellen to logMAR for ease of analysis. The change in VA and CST for each patient after completion of the treatment regimen was calculated and results were subjected to an unpaired two-tailed t-test. The Institutional Review Board granted this study a waiver of authorization.
Results :
The mean VA change in PPV eyes (N=13) receiving Q injections was a 0.075± 0.134 improvement, thus not significantly different from the control group (N=48) mean of 0.042±0.159 (p=0.4) improvement. There was no significant difference in mean number of days between injections for the study group at 42.8±6.3 and 43.6±9.8 for controls (p=0.78). The mean VA at time of first Q in PPV eyes was 0.663±0.582 logMAR ≈ 20/92 and mean final VA was 0.591±0.532 logMAR ≈ 20/78. The mean change in CST after at least three Q injections in the PPV eyes was a 60.0±64.5 µm reduction. This is statistically different from the control group mean of 11.4±67.8 µm (p=0.024) reduction in CST.
Conclusions :
Treatment of NAMD with Q in PPV eyes has no significant difference in change in VA, nor mean amount of time elapsed between injections, but does have a statistically different average reduction in CST than in non-PPV eyes. These findings refute the convention that Q is not as effective in PPV eyes as non-PPV eyes in the treatment of NAMD.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.