Remission and dropout rate of anti-VEGF therapy for age-related macular degeneration

Eur J Ophthalmol. 2011 Nov-Dec;21(6):777-82. doi: 10.5301/EJO.2011.7430.

Abstract

Purpose: Anti-vascular endothelial growth factor (VEGF) therapy is a first-line treatment for age-related macular degeneration (AMD) but frequent visits and injections can be a burden for patients. The purpose of this study is to estimate the remission rate and tolerability of anti-VEGF therapy for AMD in a clinical setting.

Methods: We investigated 90 eyes of 87 patients with AMD who underwent anti-VEGF therapy and were followed for more than 6 months. Ranibizumab and pegaptanib were used as anti-VEGF agents. Initial therapy was any of the following: a single injection, 3 consecutive monthly injections, or combination therapy with verteporfin. Additional injections were given as-needed during follow-up. An injection-free period greater than 6 months at the final observation was regarded as cessation; the reason for cessation was studied for each patient. Clinical characteristics were compared between patents with and without cessation.

Results: The mean follow-up period was 12.8 months. Mean logMAR before and 6 months after the treatment was 0.89 and 0.83, respectively. Cessation was noted in 32 eyes of 31 patients (35.6%). Remission was achieved in 13 (40.6%) of these eyes. The other cases either did not wish to undergo further treatment or dropped out. Poor baseline visual acuity (VA) was associated with cessation.

Conclusions: With current anti-VEGF therapy, remission was achieved in a limited number of AMD cases. The high frequency of voluntary cessation warrants consideration of an alternative treatment and/or supportive care for those with poor baseline VA.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Angiogenesis Inhibitors / therapeutic use*
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Aptamers, Nucleotide / therapeutic use
  • Combined Modality Therapy
  • Female
  • Follow-Up Studies
  • Humans
  • Intravitreal Injections
  • Macular Degeneration / drug therapy*
  • Macular Degeneration / physiopathology
  • Male
  • Patient Dropouts / statistics & numerical data*
  • Photochemotherapy
  • Ranibizumab
  • Remission Induction
  • Retrospective Studies
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors*
  • Visual Acuity / physiology

Substances

  • Angiogenesis Inhibitors
  • Antibodies, Monoclonal, Humanized
  • Aptamers, Nucleotide
  • VEGFA protein, human
  • Vascular Endothelial Growth Factor A
  • pegaptanib
  • Ranibizumab