LONG-TERM USE OF ANTI-VASCULAR ENDOTHELIAL GROWTH FACTOR THERAPY FOR NEOVASCULAR AGE-RELATED MACULAR DEGENERATION

Area of Science:

• Ophthalmology
• Retinal Diseases
• Medical Treatments

Background:

• Pivotal trials confirm anti-vascular endothelial growth factor (anti-VEGF) efficacy in neovascular age-related macular degeneration (nAMD).
• Limited clinical data exists on long-term (>5 years) treatment outcomes for nAMD.

Purpose of the Study:

• To evaluate the long-term (>5 years) treatment outcomes of anti-VEGF therapy in patients with nAMD.
• To assess visual acuity changes, drug durability, and safety profiles in an nAMD cohort over an extended period.

Main Methods:

• Retrospective analysis of nAMD patients receiving >40 anti-VEGF injections and followed for ≥5 years.
• Collected data included Snellen-corrected visual acuity (SCVA), initial drug choice, and treatment intervals.
• Evaluated rates of endophthalmitis and outcomes of submacular hemorrhage.

Main Results:

• 88 patients (162 eyes) with an average follow-up of 7.6 years received an average of 69 injections per eye.
• Statistically significant improvements in SCVA were observed at multiple injection points compared to baseline.
• Patients with initial SCVA of 20/40 or better maintained vision longer, while those with worse vision (≤20/50) showed initial improvement that waned.
• A low rate of endophthalmitis (0.05%) was recorded, and seven eyes experienced submacular hemorrhage.

Conclusions:

• Patients with nAMD received an average of eight anti-VEGF injections annually for approximately 8 years.
• Good initial visual acuity predicted sustained vision, whereas poorer initial vision resulted in diminishing gains over time.
• Most patients remained on their initial anti-VEGF drug, and the incidence of endophthalmitis was low.