Prospective audit of exudative age-related macular degeneration: 12-month outcomes in treatment-naive eyes

• Published in: Investigative ophthalmology & visual science 2013-08, Vol.54 (8), p.5754-5760
• Main Authors: Gillies, Mark C, Walton, Richard, Simpson, Judy M, Arnold, Jennifer J, Guymer, Robyn H, McAllister, Ian L, Hunyor, Alex P, Essex, Rohan W, Morlet, Nigel, Barthelmes, Daniel
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Angiogenesis Inhibitors - adverse effects; Angiogenesis Inhibitors - therapeutic use; Antibodies, Monoclonal, Humanized - adverse effects; Antibodies, Monoclonal, Humanized - therapeutic use; Australia; Bevacizumab; Clinical Audit; Exudates and Transudates; Female; Humans; Macular Degeneration - drug therapy; Male; Prospective Studies; Ranibizumab; Vascular Endothelial Growth Factor A - antagonists & inhibitors; Visual Acuity
• ISSN: 1552-5783; 1552-5783
• DOI: 10.1167/iovs.13-11993

We report the 12-month outcomes of 1140 treatment-naïve eyes with exudative age-related macular degeneration (wet AMD) who were treated for 12 months with intravitreal anti-VEGF drugs in routine clinical practice. Index visit characteristics, such as lesion type and size, visual acuity (VA, in Logarithm of the Minimal Angle of Resolution [logMAR] letters), as well as treatments, outcomes (VA, lesion activity status) and ocular adverse events were recorded in a prospectively designed electronic database. Index visit characteristics associated with the 12-month VA outcome were identified using mixed effects linear regression. Mean change in VA in the cohort after 12 months was +4.7 logMAR letters (95% confidence interval [CI], 3.4-6.1) with a mean of 7.0 injections. No significant difference was found in change in VA, or number of injections by type or size of the lesion. Median time to inactivation of lesions was 194 days. VA at the index visit was the strongest predictor for the 12-month outcomes. Infectious endophthalmitis occurred in 2 cases, and retinal detachment occurred in 1 case from a total of 9162 injections. These findings indicate that VEGF inhibitors can achieve reasonably good outcomes for wet AMD when used in routine clinical practice.