1. Predictors of good visual outcomes in patients with neovascular age-related macular degeneration in daily practice
- Author
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M. Prieto-del-Cura, M. Sastre-Ibañez, E. Recio-Gamo, M.-E. Fuentes-Ferrer, and I. Villafruela-Güemes
- Subjects
Male ,Vascular Endothelial Growth Factor A ,medicine.medical_specialty ,Visual acuity ,genetic structures ,Bevacizumab ,Visual Acuity ,Angiogenesis Inhibitors ,Fundus (eye) ,Loading dose ,Biomarkers, Pharmacological ,Macular Degeneration ,03 medical and health sciences ,0302 clinical medicine ,Interquartile range ,Ophthalmology ,medicine ,Humans ,Practice Patterns, Physicians' ,Aged ,Retrospective Studies ,Aged, 80 and over ,Neovascularization, Pathologic ,business.industry ,Retrospective cohort study ,Macular degeneration ,Prognosis ,medicine.disease ,eye diseases ,Regimen ,Treatment Outcome ,Intravitreal Injections ,030221 ophthalmology & optometry ,Female ,sense organs ,medicine.symptom ,business ,medicine.drug - Abstract
Summary Purpose To report predictive factors for therapeutic response to anti-VEGF in patients with neovascular age-related macular degeneration (nAMD) in daily clinical practice in our patient population. Methods Retrospective cohort study including 56 patients (69 eyes) with nAMD treated with anti-VEGF, followed for at least two years between February 2012 and April 2018. Patients received three intravitreal anti-VEGF (bevacizumab) injections (loading dose) and were monitored and treated according to a PRN regimen. We analysed whether a gain in visual acuity of 15 or more ETDRS letters at the final visit was associated with demographic characteristics, presence of systemic comorbidities, fundus lesions or measurable improvement on Cirrus optical coherence tomography (OCT) between the first and last visit. Results After a mean follow-up of 15.5 months (4.7–27.8 interquartile range), central retinal thickness (CRT) (RR: 1.004; IC 95%: 1.001–1.007; P = 0.011) and macular hemorrhage (RR: 0.30; IC 95%: 0.10–0.90, P = 0.032) at baseline were found to be useful predictive factors for visual acuity improvement (≥ 15 letters) in patients treated for nAMD by anti-VEGF in a real world clinical setting. Conclusion In the present series of patients with nAMD receiving a loading dose of bevacizumab and followed according to a PRN regimen for 24 months, the only predictable factors for a ≥ 15 letter gain in visual acuity were anatomical response as measured by OCT and macular hemorrhage at baseline.
- Published
- 2020