What question did this study set out to answer?

To evaluate real-world anti-VEGF treatment patterns, anatomic changes, and visual acuity outcomes in patients receiving treatment for neovascular age-related macular degeneration across clinical practices in the United States.

February 27, 2020OphthalmologyOpen Access

Management and Outcomes for Neovascular Age-Related Macular Degeneration

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Authors

SKSzilárd KissSemmelweis University JCJoanna CampbellAbbVie (United States)AAArghavan AlmonyUniversity of Southern California

Discussion

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Implication

Retrospective cohort study reveals limited visual acuity gains and undermedication in neovascular age-related macular degeneration, highlighting the need for more frequent anti-VEGF injections.

Key Points

To evaluate real-world anti-VEGF treatment patterns, anatomic changes, and visual acuity outcomes in patients receiving treatment for neovascular age-related macular degeneration across clinical practices in the United States.
Retrospective observational cohort study utilizing longitudinal electronic health records from the USRetina database between October 2009 and November 2016 (N = 30,106).
Assessed total ophthalmologist visits, anti-VEGF injections, optical coherence tomography scans, and fluorescein angiography procedures over 12 months stratified by initial agent (bevacizumab, ranibizumab, or aflibercept).
Evaluated primary functional and anatomical outcomes via change in visual acuity (Early Treatment Diabetic Retinopathy Study letters) and central retinal thickness at 12 months.
Patients attended a mean of 8.1 ophthalmologist visits and received a mean of 6.0 anti-VEGF injections per eye in the first 12 months, alongside 7.2 optical coherence tomography and 5.3 fluorescein angiography examinations.
Mean central retinal thickness decreased by 48 μm (from 320 to 271 μm) and mean visual acuity increased by +0.6 letters (from 60.3 to 61.0 letters); a >10-letter gain occurred in 19.3%, 15.8%, and 15.5% of bevacizumab, ranibizumab, and aflibercept eyes, respectively, while a >10-letter loss occurred in 13.2%, 14.7%, and 14.4%.
Visual acuity gains correlated linearly with injection frequency (+1.79 letters with ≥7 injections vs -0.95 letters with <7 injections), with multivariate linear regression showing an estimated gain of 0.37 letters per additional injection.

Cite This Study

Kiss et al. (2020) studied this question.

synapsesocial.com/papers/6a76563464b2b4ebb1088009 https://doi.org/10.1016/j.ophtha.2020.02.027

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Implication

Retrospective cohort study reveals limited visual acuity gains and undermedication in neovascular age-related macular degeneration, highlighting the need for more frequent anti-VEGF injections.