Subretinal injection of anti-vascular endothelial growth factor in the treatment of refractory neovascular age-related macular degeneration

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Purpose: To describe the anatomical and visual effects of subretinal injection of anti-vascular endothelial growth factor in the treatment of refractory neovascular age-related macular degeneration. Methods: Seventeen patients with refractory neovascular age-related macular degeneration were enrolled in a prospective study. All patients were injected with 0.5 mg/0.05 ml conbercept into the macular subretinal area with 41G precision microneedles. Results: Seventeen patients (9 males and 8 females) with a mean age of 76.24±7.23 years (range 67–91 years) were followed up for a period of twelve months. The best-corrected visual acuity improved from 1.282±0.261 logMAR preoperatively to 1.046±0.255 logMAR 12 months after surgery. The macular retinal thickness decreased from 365.82±89.41 μm before surgery to 179.24±40.92 μm 12 months after surgery. The number of injections ranged from 1 to 3: once in 12 eyes (70.59%), twice in 4 eyes (23.53%), and three times in 1 eye (5.88%). No surgery-related complications were recorded in any of the study eyes. Conclusions: Subretinal injection of anti-VEGF appears to be an effective treatment for refractory neovascular age-related macular degeneration. However, further studies are needed to analyse prognostic factors affecting functional and anatomic outcomes.