Benjamin Wolff1, Valerie Macioce2, Vivien Vasseur1,3, Laurent Castelnovo1, Guillaume Michel1, Vuong Nguyen4, Vincent Daien5,6, Martine Mauget-Faÿsse3, Mark Gillies4. 1. Maison Rouge Ophthalmologic Centre, Strasbourg, France. 2. Clinical Research and Epidemiology Unit, CHU Montpellier, University of Montpellier, Montpellier, France. 3. Research Department, Rothschild Foundation, Paris, France. 4. The Save Sight Institute, Sydney Medical School, The University of Sydney, Sydney, Australia. 5. Department of Ophthalmology, Gui de Chauliac Hospital, Montpellier, France. 6. Inserm, U1061, Montpellier, France.
Abstract
IMPORTANCE: Long-term data of intravitreal injections of vascular endothelial growth factor (VEGF) inhibitors are lacking. BACKGROUND: This study aims to assess visual and anatomic outcomes of eyes with neovascular age-related macular degeneration (nAMD) after 10 years of anti-VEGF therapy. DESIGN: Retrospective analysis of data from a prospectively designed database. PARTICIPANTS: One hundred and sixteen eyes with nAMD (94 participants) that started anti-VEGF therapy at least 10 years earlier. METHODS: Eyes were tracked by the Fight Retinal Blindness! registry. MAIN OUTCOME MEASURES: Mean change in visual acuity at 10 years vs baseline. Visual acuity was assessed by the number of letters read on a logarithm of the minimum angle of resolution chart. RESULTS: Eyes received a median of 27.5 injections over 10 years. Mean visual acuity was 57.5 letters (SD 17.5) at baseline. It increased slightly at 1 year, then dropped steadily by 18 letters (95% CI: 13.7; 22.3) at 10 years. Overall, 10% of eyes gained ≥10 letters, 64% lost ≥10 letters and 23% remained stable (±5 letters from baseline). Geographic atrophy and subretinal fibrosis were found in 93% and 71%, respectively, after 10 years, both mostly affecting the centre of the fovea. Pre-treated eyes (47.5%) had significantly worse visual acuity than treatment-naïve eyes at baseline and during follow-up and were significantly more likely to have atrophy and fibrosis. CONCLUSIONS AND RELEVANCE: Despite short-term stabilization, long-term visual outcomes of nAMD eyes under anti-VEGF therapy may be poor. Development of atrophy and fibrosis, resulting from the natural progression of the disease, may partly explain this evolution.
IMPORTANCE: Long-term data of intravitreal injections of vascular endothelial growth factor (VEGF) inhibitors are lacking. BACKGROUND: This study aims to assess visual and anatomic outcomes of eyes with neovascular age-related macular degeneration (nAMD) after 10 years of anti-VEGF therapy. DESIGN: Retrospective analysis of data from a prospectively designed database. PARTICIPANTS: One hundred and sixteen eyes with nAMD (94 participants) that started anti-VEGF therapy at least 10 years earlier. METHODS: Eyes were tracked by the Fight Retinal Blindness! registry. MAIN OUTCOME MEASURES: Mean change in visual acuity at 10 years vs baseline. Visual acuity was assessed by the number of letters read on a logarithm of the minimum angle of resolution chart. RESULTS: Eyes received a median of 27.5 injections over 10 years. Mean visual acuity was 57.5 letters (SD 17.5) at baseline. It increased slightly at 1 year, then dropped steadily by 18 letters (95% CI: 13.7; 22.3) at 10 years. Overall, 10% of eyes gained ≥10 letters, 64% lost ≥10 letters and 23% remained stable (±5 letters from baseline). Geographic atrophy and subretinal fibrosis were found in 93% and 71%, respectively, after 10 years, both mostly affecting the centre of the fovea. Pre-treated eyes (47.5%) had significantly worse visual acuity than treatment-naïve eyes at baseline and during follow-up and were significantly more likely to have atrophy and fibrosis. CONCLUSIONS AND RELEVANCE: Despite short-term stabilization, long-term visual outcomes of nAMD eyes under anti-VEGF therapy may be poor. Development of atrophy and fibrosis, resulting from the natural progression of the disease, may partly explain this evolution.
Authors: Philipp K Roberts; Markus Schranz; Alice Motschi; Sylvia Desissaire; Valentin Hacker; Michael Pircher; Stefan Sacu; Wolf Buehl; Christoph K Hitzenberger; Ursula M Schmidt-Erfurth Journal: Sci Rep Date: 2022-01-07 Impact factor: 4.379
Authors: Philipp Ken Roberts; Markus Schranz; Alice Motschi; Sylvia Desissaire; Valentin Hacker; Michael Pircher; Stefan Sacu; Wolf Buehl; Christoph Konrad Hitzenberger; Ursula Schmidt-Erfurth Journal: Transl Vis Sci Technol Date: 2021-12-01 Impact factor: 3.283
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Authors: Beau J Fenner; Chui Ming Gemmy Cheung; Shaun S Sim; Won Ki Lee; Giovanni Staurenghi; Timothy Y Y Lai; Paisan Ruamviboonsuk; Gregg Kokame; Yasuo Yanagi; Kelvin Y C Teo Journal: Eye (Lond) Date: 2021-07-14 Impact factor: 3.775