Long Term Use of Anti-Vascular Endothelial Growth Factor Therapy for Neovascular Age-Related Macular Degeneration.
Retina (Philadelphia, Pa.)
PURPOSE: While pivotal trials have demonstrated efficacy of anti-vascular endothelial growth factor (VEGF) therapy in neovascular age-related macular degeneration (nAMD), there is a paucity of clinical data about the long term (>5 years) treatment.
METHODS: Retrospective analysis of all patients with nAMD who were actively treated, had received >40 anti-VEGF injections, and were followed for ≥5 years. Snellen corrected visual acuity (SCVA), initial drug choice, and times elapsed between treatment were collected. Rates of endophthalmitis and outcomes of submacular hemorrhage were also evaluated.
RESULTS: A total of 88 patients (162 eyes) met the inclusion criteria: the average patient was 86.3 years with an average follow up period of 7.6 years. The average total number of injections per eye was 69 (18.0 std dev); a total of 11,208 injections were given throughout the study period and 6 (0.05%) cases of endophthalmitis were observed. Overall, there was a clinical and statistical difference in average SCVA at injections #2,#3, #4, #5, #6, #10 and #20, as compared with baseline (p=0.03, p
CONCLUSIONS: The nAMD cohort herein received on average 8 anti-VEGF injections per year for approximately 8 years; eyes with good (≥20/40) initial baseline vision maintained their VA while eyes with worse SCVA (≤20/50) had a robust initial improvement that diminished with time. Most patients were maintained on the same initial drug of choice and the rate of endo11phthalmitis was low.
Begaj T, Jeong D, Park JG, Runner MM, Capone A Jr, Dass AB, et al [ Drenser KA, Faia LJ, Garretson BR, Hassan TS, Mahmoud TH, Randhawa S, Ruby AJ, Sneed S, Wolfe JD, Williams GA] Long term use of anti-vascular endothelial growth factor therapy for neovascular age-related macular degeneration. Retina. 2023 Oct 26. doi: 10.1097/IAE.0000000000003961. Epub ahead of print. PMID: 37903288.