gms | German Medical Science

Purpose: For neovascular age-related macular degeneration (nAMD), data from real-life studies on functional and anatomic outcomes of anti-VEGF treatment is still limited. Therefore, we assessed the Results of anti-VEGF therapy in our patients with a long-term follow-up.

Methods: In this retrospective monocenter study, patients were included with newly diagnosed nAMD that had received minimally three intravitreal injections between January 1, 2006 and June 30, 2014 at the University Hospital, Ludwig-Maximilians-University Munich, Germany, with a follow-up period of ≥ 60 months. Primary outcome measures were the evolution of best-corrected visual acuity (BCVA) and central macular thickness (CMT) on spectral-domain optical coherence tomography (OCT). Secondary outcome measures were number of intravitreal injections (IVT) and follow-up visits, treatment strategy and switch as well as evolution of morphologic features such as macular atrophy, pigment epithelium detachment and retinal tubulations. For qualitative, quantitative and longitudinal data, Pearson&#039;s chi2 test, the Mann-Whitney U-test and Wilcoxon&#039;s signed-rank test were applied at a significance level of p?<?0.05.

Results: Of 1034 eyes (861 patients) with nAMD treated during this period, 149 eyes (123 patients) had been newly diagnosed and were consistently followed for at least 60 months. Mean follow-up period was 8.0 years (median 7.8, range 5.0–13.2 years). Mean BCVA at baseline was 0.51±0.30 LogMAR and improved to 0.42±0.30 LogMAR with a mean number of 5.3±2.3 injections during the first year. Mean number of anti-VEGF injections was 28.8±16.1 (median 26, 3-67 injections). At year 5, 19.5% of eyes declined by 15 letters or more. Pro re nata (PRN) regimen was started in the majority of eyes at baseline (95.1%) and changed to treat&extent (T&E) in 59.8% over the period of treatment. Treatment switch was documented in 103/149 (69.1%) eyes, mostly from ranibizumab to aflibercept (83.2%). In 21.3% of eyes, treatment was re-switched during the follow-up period. At time of last follow-up, 104 eyes (69.8%) were still under active treatment. These are preliminary data. Data from SD-OCT analysis are pending.

Conclusions: The herein presented real-life data provide an estimate of visual function developments and injection frequencies for counselling patients undergoing long-term anti-VEGF therapy.