RT Journal Article
SR Electronic
T1 Ten-year survival trends of neovascular age-related macular degeneration at first presentation
JF British Journal of Ophthalmology
JO Br J Ophthalmol
FD BMJ Publishing Group Ltd.
SP 1688
OP 1695
DO 10.1136/bjophthalmol-2020-317161
VO 105
IS 12
A1 Arpa, Cristina
A1 Khalid, Hagar
A1 Chandra, Shruti
A1 Wagner, Siegfried
A1 Fasler, Katrin
A1 Faes, Livia
A1 Pooprasert, Pakinee
A1 Chopra, Reena
A1 Moraes, Gabriella
A1 Balaskas, Konstantinos
A1 Keane, Pearse A
A1 Sivaprasad, Sobha
A1 Fu, Dun Jack
YR 2021
UL http://bjo.bmj.com/content/105/12/1688.abstract
AB Background To describe 10-year trends in visual outcomes, anatomical outcomes and treatment burden of patients receiving antivascular endothelial growth factor (anti-VEGF) therapy for neovascular age-related macular degeneration (nAMD).Methods Retrospective cohort study of treatment-naïve, first-affected eyes with nAMD started on ranibizumab before January 1, 2009. The primary outcome was time to best-corrected visual acuity (BCVA) falling ≤35 ETDRS letters after initiating anti-VEGF therapy. Secondary outcomes included time to BCVA reaching ≥70 letters, proportion of eyes with BCVA ≥70 and ≤35 letters in 10 years, mean trend of BCVA and central retinal thickness over 10 years, and mean number of injections.Results For our cohort of 103 patients, Kaplan-Meier analyses demonstrated median time to BCVA reaching ≤35 and ≥70 letters were 37.8 (95% CI 22.2 to 65.1) and 8.3 (95% CI 4.8 to 20.9) months after commencing anti-VEGF therapy, respectively. At the final follow-up, BCVA was ≤35 letters and ≥70 letters in 41.1% and 21%, respectively, in first-affected eyes, while this was the case for 5.4% and 48.2%, respectively, in a patient’s better-seeing eye. Mean injection number was 37.0±24.2 per eye and 53.6±30.1 at patient level (63.1% of patients required injections in both eyes).Conclusions The chronicity of nAMD disease and its management highlights the importance of long-term visual prognosis. Our analyses suggest that one in five patients will retain good vision (BCVA ≥70 ETDRS letters) in the first-affected eye at 10 years after starting anti-VEGF treatment; yet, one in two patients will have good vision in their better-seeing eye. Moreover, our data suggest that early treatment of nAMD is associated with better visual outcomes.