Long Term Use of Anti-Vascular Endothelial Growth Factor Therapy for Neovascular Age-Related Macular Degeneration.

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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.





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