Article Text

Multi-country real-life experience of anti-vascular endothelial growth factor therapy for wet age-related macular degeneration
  1. Frank G Holz1,
  2. Ramin Tadayoni2,
  3. Stephen Beatty3,
  4. Alan Berger4,
  5. Matteo G Cereda5,
  6. Rafael Cortez6,
  7. Carel B Hoyng7,
  8. Philip Hykin8,
  9. Giovanni Staurenghi5,
  10. Stephanie Heldner9,
  11. Timon Bogumil10,
  12. Theresa Heah10,
  13. Sobha Sivaprasad8,11
  1. 1Department of Ophthalmology, University of Bonn, Bonn, Germany
  2. 2Department of Ophthalmology, Hôpital Lariboisière, AP-HP, Université Paris 7—Sorbonne Paris Cité, France
  3. 3Department of Ophthalmology, Institute of Eye Surgery, Waterford, Ireland
  4. 4Department of Ophthalmology and Vision Sciences, University of Toronto, and St Michael's Hospital, Toronto, Canada
  5. 5Department of Biomedical and Clinical Science Luigi Sacco, Luigi Sacco Hospital, University of Milan, Milan, Italy
  6. 6Centro de Cirugia Oftalmologica, Caracas, Venezuela
  7. 7Department of Ophthalmology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
  8. 8NIHR Biomedical Centre for Research in Ophthalmology, Moorfields Eye Hospital, London, UK
  9. 9Bayer HealthCare Pharmaceuticals, Berlin, Germany
  10. 10Bayer HealthCare Pharmaceuticals, Montville, New Jersey, USA
  11. 11King's College Hospital, London, UK
  1. Correspondence to Sobha Sivaprasad, King's College Hospital, Denmark Hill, London SE5 9RS, UK; senswathi{at}


Background/aims Real-life anti-vascular endothelial growth factor (VEGF) therapy use in patients with wet age-related macular degeneration (wAMD) was assessed in a retrospective, observational study in Canada, France, Germany, Ireland, Italy, the Netherlands, UK and Venezuela.

Methods Medical records of patients with wAMD, who started ranibizumab treatment between 1 January 2009 and 31 August 2009, were evaluated. Data were collected until the end of treatment and/or monitoring or until 31 August 2011.

Results 2227 patients who received ≥1 anti-VEGF injection with a baseline visual acuity assessment and ≥1 postbaseline visual acuity assessment for the treated eye were evaluated. Visual acuity improved until about day 120; thereafter, visual acuity gains were not maintained. Mean change in visual acuity score from baseline to years 1 and 2 was +2.4 and +0.6 letters, respectively. Patients received a mean of 5.0 and 2.2 injections in the first and second year, respectively. There were substantial differences in visual outcomes and injection frequency between countries. More frequent visits and injections were associated with greater improvements in visual acuity.

Conclusions In clinical practice, fewer injections are administered than in clinical trials. Anti-VEGF treatment resulted in an initial improvement in visual acuity; however, this was not maintained over time.

Trial registration number NCT01447043.

  • Degeneration
  • Macula
  • Treatment Medical

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:

View Full Text

Statistics from

Supplementary materials

  • Supplementary Data

    This web only file has been produced by the BMJ Publishing Group from an electronic file supplied by the author(s) and has not been edited for content.

    Files in this Data Supplement:

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Linked Articles

  • At a glance
    Keith Barton James Chodosh Jost Jonas