Association between visual acuity, lesion activity markers and retreatment decisions in neovascular age-related macular degeneration.

ABSTRACT: BACKGROUND/OBJECTIVES:To investigate the association between optical coherence tomography (OCT) markers of lesion activity and changes in visual acuity (VA) during anti-vascular endothelial growth factor (anti-VEGF) therapy of eyes diagnosed with neovascular age-related macular degeneration (nAMD); and how VA and OCT markers are considered in physicians' decision to retreat with anti-VEGFs. SUBJECTS/METHODS:Retrospective, non-comparative, non-randomised cohort study involving electronic medical record data collected from 1190 patient eyes with nAMD diagnosis at two sites in the United Kingdom. Two sub-cohorts consisting of 321 and 301 eyes, respectively, were selected for analyses. RESULTS:In 321 eyes, absence of IRF or SRF at ?2 clinic visits resulted in a gain of five ETDRS letters from baseline, compared with two letters gained in eyes with <2 clinic visits with absence of IRF (p?=?0.006) or SRF (p?=?0.042). Anti-VEGF treatment was administered at 421 clinic visits, and 308 visits were without treatment. Comparing treatment visits with non-treatment visits, the maximum difference in frequency of OCT markers of lesion activity were for intraretinal fluid (IRF; 24% versus 5%) and subretinal fluid (SRF; 32% versus 5%). Pigment epithelial detachment (PED) was reported in 58% of treatment visits compared with 36% in non-treatment visits. VA loss was not a consistent trigger for retreatment as it was present in 63% of injection visits and in 49% of non-injection visits. CONCLUSIONS:Retreatment decision making is most strongly influenced by the presence of IRF and SRF and less by the presence of PED or VA loss.

SUBMITTER: Chakravarthy U 

PROVIDER: S-EPMC7784949 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature