Abstract
Purpose :
Anti-vascular endothelial growth factor (VEGF) therapy for age-related macular degeneration (AMD) requires long-term treatment, but many patients drop out of treatment. This time, we investigated the causes of deviation and dropout from anti-VEGF monotherapy for AMD.
Methods :
Of the 90 untreated AMD patients who started aflibercept monotherapy at our hospital between April 2016 and March 2020, 55 patients who dropped out within 5 years of starting treatment were included in the study. We retrospectively investigated the causes of dropout from treatment using medical records.
Results :
The period from start of treatment to withdrawal was less than 1 year in 28 cases, 1 to 2 years in 10 cases, 2 to 3 years in 12 cases, 3 to 4 years in 4 cases, and 4 to 5 years in 1 case. The reasons for dropping out of treatment were self-discontinuation in 20 patients, macular atrophy and scarring in 7 patients, and systemic/ocular complications and hospital transfer in 5 patients each. The patients who dropped out due to changes in treatment strategy were 8 patients received photodynamic therapy (PDT) in combination, 4 patients changed to other drugs, 3 patients who received a tissue plasminogen activator for submacular hemorrhage, and 1 patient who received a combination of eplerenone and retinal photocoagulation.
Conclusions :
Anti-VEGF therapy is a standard treatment for AMD, but there are a certain number of cases that require changes in treatment strategy, such as combining PDT or switching to other drugs. In addition, the most common cause of dropout in the early stages of treatment is hospital visits and treatment interruptions. It is necessary to provide continuous patient explanations during treatment to minimize interruptions due to poor adherence.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.