Younger patients with small lesions unlikely to see nAMD recurrence

In neovascular age-related macular degeneration (nAMD), the absence of exudative recurrence after three loading doses of antivascular endothelial growth factor (VEGF) is associated with younger age, smaller lesion size, and having no fibrovascular pigment epithelial detachment (PED), a recent study has found.

Researchers retrospectively assessed 392 nAMD patients, all of whom underwent treatment with three monthly loading doses of anti-VEGF injections, followed by a pro re nata regimen for 24 months. Fifty-eight (14.8 percent) eyes did not develop exudative recurrence and required no additional anti-VEGF injections.

Patients who did not develop exudative recurrence were significantly younger at baseline (mean, 63.6 vs 70.0 years; p=0.013) and had smaller mean lesion size (1.08 vs 2.25 mm²; p=0.008). Fibrovascular PED was likewise less common in patients without recurrence (55.2 percent vs 70.4 percent; p=0.022).

Multivariate logistic regression analysis confirmed that these three factors were significantly associated with lower odds of exudative recurrence. Younger age at baseline, for example, reduced such likelihood by 10 percent (odds ratio [OR], 0.901, 95 percent confidence interval [CI], 0.831–0.979; p=0.033).

Similar and stronger effects were reported for smaller lesion size (OR, 0.589, 95 percent CI, 0.383–0.901; p=0.016) and having no fibrovascular PED (OR, 1.349, 95 percent CI, 1.226–2.884; p=0.028).

“Identifying the predictive factors at baseline might be clinically relevant, as this information allows clinicians to categorize patients better and provide individualized anti-VEGF treatments,” the researchers said.