Ten-Year Real-World Outcomes of Anti-Vascular Endothelial Growth Factor Therapy in Neovascular Age-Related Macular Degeneration
Received 2 July 2020
Accepted for publication 27 November 2020
Published 22 January 2021 Volume 2021:15 Pages 279—287
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Dr Scott Fraser
Muhammad Raza Cheema, Joanna DaCosta, James Talks
Department of Ophthalmology, Royal Victoria Infirmary, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
Correspondence: Muhammad Raza Cheema
Department of Ophthalmology, Royal Victoria Infirmary, Newcastle Upon Tyne NE1 4LP, UK
Background: Neovascular age-related macular degeneration (nAMD) has been treated with anti-vascular endothelial growth factor (anti-VEGF) therapy since 2006 with initial efficacy evidence of 2 years. In many, long-term therapy is required, and evidence for benefit is required from real-world data collection.
Methods: Retrospective review of electronic medical records of a consecutive series of patients treated with anti-VEGF therapy for nAMD over a 10-year period. Age, lens status and loss to follow-up was recorded. Primary outcome was change in VA at 10 years; secondary outcomes included proportion of eyes losing < 15 letters at 3, 5, 7 and 10 years, number of injections and anatomic outcome.
Results: Of 196 patients (197 eyes), 90 patients had 10 years of follow-up data. Visual acuity (VA) declined by − 11.2 letters (p=0.001), but 63.3% of eyes lost ≤ 15 letters. The proportion of eyes maintaining ≥ 70 letters was 17.7%, and the mean number of injections (±SD) was 47 ± 16. Retinal fluid was still present in 72.2% of eyes at 10 years. Forty-six percent of patients continued to receive anti-VEGF injections 10 years after treatment was commenced.
Conclusion: Anti-VEGF treatment for nAMD over a ten-year period showed 63.3% of eyes lost ≤ 15 letters. Eyes with better baseline vision were more likely to continue receiving anti-VEGF treatment, but the frequency of injection treatment decreased.
Keywords: neovascular age-related macular degeneration, visual acuity, real-world, anti-vascular endothelial growth factor injections
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