Impact of Treating Age-Related Macular Degeneration before Visual Function Is Impaired

Area of Science:

• Ophthalmology
• Retinal Diseases
• Medical Treatments

Background:

• Age-related macular degeneration (AMD) treatment has advanced with anti-vascular endothelial growth factor (anti-VEGF) therapies.
• Individual responses to anti-VEGF treatment for AMD vary significantly.
• Understanding predictors of treatment success is crucial for optimizing patient outcomes.

Purpose of the Study:

• To identify predictors of maintained or improved best-corrected visual acuity (BCVA) in eyes with AMD treated with anti-VEGF therapy.
• To analyze factors influencing visual outcomes and survival rates in AMD patients undergoing anti-VEGF treatment.
• To evaluate the impact of initial visual acuity and lesion characteristics on treatment efficacy.

Main Methods:

• Retrospective analysis of medical charts from 104 eyes (104 patients) with AMD treated with anti-VEGF drugs.
• Logistic regression analyses adjusted for age to identify predictors of BCVA.
• Kaplan-Meier survival analysis to assess visual survival rates, with failure defined as a BCVA reduction of ≥ 0.2 logMAR.

Main Results:

• Initial BCVA < 0.3 logMAR was a positive predictor of maintained or improved BCVA (OR = 3.172, p = 0.045).
• Presence of initial fibrovascular pigment epithelial detachment (PED) was a negative predictor (OR = 0.222, p = 0.005).
• Eyes with initial BCVA < 0.3 logMAR showed better visual survival rates (HR = 2.947, p = 0.041) and were associated with younger patients and less advanced lesions.

Conclusions:

• Initiating anti-VEGF treatment earlier, before significant BCVA decline and advanced lesion development, is associated with better visual outcomes in clinical practice.
• Initial visual acuity and the absence of fibrovascular PED are key factors in predicting treatment success for AMD.
• Further research is warranted to refine treatment strategies and improve long-term visual function in AMD patients.