J Korean Ophthalmol Soc.  2018 Nov;59(11):1030-1038. 10.3341/jkos.2018.59.11.1030.

Significance of Early Visual Responses to Anti-Vascular Endothelial Growth Factor in Age-related Macular Degeneration

• Song HJ
• Yang JH
• Kim DG

• KMID: 2426364
• DOI: http://doi.org/10.3341/jkos.2018.59.11.1030

Abstract

PURPOSE
To evaluate whether early visual acuity response at 4 weeks after the first intravitreal anti-vascular endothelial growth factor (VEGF) injection or 4 weeks after the third injection in neovascular age-related macular degeneration (nAMD) is associated with 12-month follow-up outcome.
METHODS
Thirty treatment-naive patients (30 eyes) with nAMD, treated with intravitreal anti-VEGF, were retrospectively included. Initially, all patients were injected at least three times for three consecutive months and followed up with a pro re nata regimen for at least 12 months. The relationship between 4 weeks after the first and third anti-VEGF injections in visual acuity response was explored, including the mean change from baseline in best-corrected visual acuity (BCVA). The mean change in BCVA was classified into three groups according to visual improvement: <1, 1-<3, or ≥ 3 logMAR line(s) in BCVA. The associations among baseline characteristics (gender, age, duration of symptoms, initial BCVA, central macular thickness, and intraocular pressure) and visual acuity responses 4 weeks after the first and third anti-VEGF injections were also assessed.
RESULTS
The proportions of eyes with <1, 1-<3, and ≥ 3-line(s) improvement at 4 weeks after the first injection were 6 eyes (20%), 7 eyes (23.3%), and 17 eyes (56.6%), respectively. The proportions of eyes with <1, 1-<3, and ≥ 3-line(s) improvement at 4 weeks after the third injection were 9 eyes (30%), 9 eyes (30%), and 12 eyes (40%), respectively. A BCVA response ≥ 3-lines improvement at 4 weeks after the third injection showed significant associations with ≥ 3-lines improvement and BCVA response at 12 months in multiple logistic and linear regression analyses (p = 0.04).
CONCLUSIONS
In this study, BCVA response ≥ 3-lines improvement at 4 weeks after the third injection showed a significant association with ≥ 3-lines improvement and BCVA response at 12 months.

Keyword

Anti-vascular endothelial growth factor; Early response; Neovascular age-related macular degeneration; Visual response

MeSH Terms

Endothelial Growth Factors*
Follow-Up Studies
Humans
Linear Models
Macular Degeneration*
Retrospective Studies
Visual Acuity
Endothelial Growth Factors

Figure

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  Figure 1. The visual acuity (VA) response category (≥3 line improvement, 1-<3 line improvement, <1 line improvement) at year 1 by the early VA response category at 1 month after 1st anti-VEGF injection or at 1 month after 3rd anti-VEGF injection. VA response category at 1 year by VA response at 1 month after 1st anti-VEGF injection (A), and VA response category at 1 year by VA response at 1 month after 3rd anti-VEGF injection (B). VEGF = vascular endothelial growth factor.

Reference

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