Anti-VEGF shows long-term potential against neovascular AMD

Treatment with antivascular endothelial growth factor (anti-VEGF), along with regular monitoring, minimizes the risk of long-term vision loss in patients with neovascular age-related macular degeneration (AMD), a recent study has shown.

The study included 149 eyes from 149 neovascular AMD patients (mean age, 74.5±7.8 years) who were on anti-VEGF therapy. Eyes were divided into two groups according to the primary outcome measure of change in visual acuity (VA) over 10 years of treatment: those with gain of ≥10 letters (good visual outcomes) or with loss of ≥15 letters (worse visual outcomes).

At baseline, the mean VA was 59.5±13.1 ETDRS* letters and the average foveal thickness was 298.7±87.9 µm. Fifteen eyes showed evidence of atrophy at enrolment. Patients were followed up for a mean of 3,667.4±15 days, or 10.04 years.

At the final follow-up, the average change in VA in the overall cohort was –2.1±19.9 letters. Good vision, defined as having a final best-corrected VA (BCVA) of 20/40 or better, was recorded in 33.5 percent of the eyes. Most of the eyes (76.5 percent) saw loss of <15 letters from baseline, though 20 eyes became legally blind, with a BCVA of 20/200 or worse.

Thirty-seven eyes (24.8 percent) gained >10 letters, while loss of ≥15 letters was seen in 23.5 percent of the eyes. Notably, a large drop in VA was reported in 16 eyes, which logged a decrease of ≥30 letters from baseline.

“[T]he current study strongly suggests that by 10 years, in patients with neovascular AMD, good VA outcomes can be achieved and maintained with anti-VEGF therapy in clinical practice,” researchers said.

*Early Treatment Diabetic Retinopathy Study