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Outcomes of persistently active neovascular age-related macular degeneration treated with VEGF inhibitors: observational study data
  1. Daniel Barthelmes1,2,
  2. Richard Walton1,
  3. Anna E Campain1,
  4. Judy M Simpson3,
  5. Jennifer J Arnold4,
  6. Ian L McAllister5,
  7. Robyn H Guymer6,
  8. Alex P Hunyor1,7,
  9. Rohan W Essex8,
  10. Nigel Morlet9,
  11. Mark C Gillies1,
  12. for the Fight Retinal Blindness! Project Investigators
  1. 1The Save Sight Institute, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
  2. 2Department of Ophthalmology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
  3. 3Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia
  4. 4Marsden Eye Specialists, Parramatta, New South Wales, Australia
  5. 5The Lions Eye Institute, Perth, Western Australia, Australia
  6. 6Center for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
  7. 7Retina Associates, Chatswood, New South Wales, Australia
  8. 8Department of Ophthalmology, Canberra Hospital, Garran, Australian Capital Territory, Australia
  9. 9Department of Population Health, University of Western Australia, Perth, Western Australia, Australia
  1. Correspondence to Professor Mark Gillies, Save Sight Institute, South Block, 8 Macquarie St., Sydney, NSW 2001, Australia; mark.gillies{at}


Aim To describe outcomes of eyes with wet age-related macular degeneration (AMD) subdivided by lesion activity in a large multicentre cohort study.

Methods Treatment-naive eyes with subfoveal choroidal neovascularisation receiving antivascular endothelial growth factor therapy enrolled in the Fight Retinal Blindness observational study were included. Lesions were graded at each visit as active if there was intraretinal or subretinal fluid attributable to leak from choroidal neovascularisation lesion or fresh haemorrhage. Eyes were divided into four groups; based on the proportion of visits, each eye was graded as active during the first 12 months of treatment (persistent, high, moderate and low activity).

Results 655 eyes were included. Similar mean visual acuity changes compared with baseline were observed in all four groups at 12 months (+6.8, +8.3, +6.2 and +5.5 letters for the low, moderate, high and persistent groups, respectively; p<0.001 for each group). The mean number of injections given increased only modestly in groups with more active lesions (7.6, 7.9, 8.4 and 8.3, respectively, p=0.015). Occult and minimally classic lesions were more frequent in the more active groups (p=0.024).

Conclusions Persistent activity of neovascular lesions during 12 months after starting intravitreal therapy was not associated with worse visual outcomes in this observational study of AMD.

  • Macula
  • Retina
  • Vision
  • Neovascularisation

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