TY - JOUR
T1 - Correlation of baseline visual acuity with outcomes of treatment with anti-VEGF in neovascular age-related macular degeneration
AU - Veluswamy, Balaji
AU - Lee, Andy
AU - Mirza, Rukhsana G.
AU - Gill, Manjot K.
N1 - Publisher Copyright:
© 2020 Veluswamy et al.
PY - 2020
Y1 - 2020
N2 - Purpose: Neovascular age-related macular degeneration (nv-AMD) is the leading cause of blindness in individuals 55 years and older. The advent of anti-vascular endothelial growth factor (anti-VEGF) therapy has greatly altered the visual acuity (VA) prognosis in these patients. While many studies have described treatment outcomes, few have explored the impact of early detection on VA outcomes. Patients and Methods: This retrospective cohort study consisted of treatment-naïve eyes with nv-AMD (ICD9 diagnosis code 362.52) that were treated with bevacizumab, ranibizumab, and aflibercept by four physician investigators in a large urban tertiary center from March 2008 to October 2015. Eyes were categorized by baseline VA into good (20/50 or better), intermediate (20/50–20/200), and poor (20/200 or worse) initial VA. VA and optical coherence tomography (OCT) findings were evaluated throughout the treatment period. Results: 224 eyes were evaluated. Of eyes with good, intermediate, and poor initial VA, 14.1%, 37.2%, and 58.3% showed an increase in 2 or more lines of vision on LogMAR, respectively [p < 0.001], while 71.8%, 40.7%, and 16.7% of eyes had a final VA of 20/50 or better, respectively [p < 0.001]. Average final Snellen VA in eyes with good, intermediate, and poor initial VA was 20/47, 20/96, and 20/277, respectively. Change in VA for good, intermediate, and poor initial VA groups was ΔLogMAR of +0.117, +0.041, and −0.230, respectively. Of eyes with good, intermediate, and poor baseline VA, 42.3%, 20.9%, and 20.0%, respectively, showed resolution of fluid on OCT [p = 0.003]. Conclusion: Patients with good initial VA were more likely to maintain good vision and show resolution of fluid on OCT through follow-up. Patients with poor initial VA tended to gain more vision, however, had poorer final VA. This underscores the importance of early detection and treatment of nv-AMD in maintaining superior outcomes.
AB - Purpose: Neovascular age-related macular degeneration (nv-AMD) is the leading cause of blindness in individuals 55 years and older. The advent of anti-vascular endothelial growth factor (anti-VEGF) therapy has greatly altered the visual acuity (VA) prognosis in these patients. While many studies have described treatment outcomes, few have explored the impact of early detection on VA outcomes. Patients and Methods: This retrospective cohort study consisted of treatment-naïve eyes with nv-AMD (ICD9 diagnosis code 362.52) that were treated with bevacizumab, ranibizumab, and aflibercept by four physician investigators in a large urban tertiary center from March 2008 to October 2015. Eyes were categorized by baseline VA into good (20/50 or better), intermediate (20/50–20/200), and poor (20/200 or worse) initial VA. VA and optical coherence tomography (OCT) findings were evaluated throughout the treatment period. Results: 224 eyes were evaluated. Of eyes with good, intermediate, and poor initial VA, 14.1%, 37.2%, and 58.3% showed an increase in 2 or more lines of vision on LogMAR, respectively [p < 0.001], while 71.8%, 40.7%, and 16.7% of eyes had a final VA of 20/50 or better, respectively [p < 0.001]. Average final Snellen VA in eyes with good, intermediate, and poor initial VA was 20/47, 20/96, and 20/277, respectively. Change in VA for good, intermediate, and poor initial VA groups was ΔLogMAR of +0.117, +0.041, and −0.230, respectively. Of eyes with good, intermediate, and poor baseline VA, 42.3%, 20.9%, and 20.0%, respectively, showed resolution of fluid on OCT [p = 0.003]. Conclusion: Patients with good initial VA were more likely to maintain good vision and show resolution of fluid on OCT through follow-up. Patients with poor initial VA tended to gain more vision, however, had poorer final VA. This underscores the importance of early detection and treatment of nv-AMD in maintaining superior outcomes.
KW - AMD
KW - Anti-VEGF therapy
KW - Vision
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U2 - 10.2147/OPTH.S256009
DO - 10.2147/OPTH.S256009
M3 - Article
C2 - 32606571
AN - SCOPUS:85086650655
SN - 1177-5467
VL - 14
SP - 1565
EP - 1572
JO - Clinical Ophthalmology
JF - Clinical Ophthalmology
ER -