Baseline visual acuity as a prognostic factor for visual outcomes in patients treated with aflibercept for wet age-related macular degeneration: data from the INSIGHT study using the Swedish Macula Register

Purpose: This article assesses anatomical and visual outcomes after intravitreal antivascular endothelial growth factor (anti-VEGF) treatment in fellow eyes with wet age-related macular degeneration (AMD). Methods: A retrospective chart review was conducted of 349 patients diagnosed with wet AMD between 2005 and 2017 at a single academic institution. Initial diagnosis of unilateral wet AMD and a minimum follow-up time of 1 year after diagnosis were required for inclusion. Individuals were excluded if the initial diagnosis of wet AMD was made at an outside institution, if they had received prior treatment at another institution, or if they had bilateral wet AMD at the time of inclusion. Best-corrected visual acuity, optical coherence tomography (OCT) parameters, and frequency and type of intravitreal anti-VEGF injections were recorded. MedCalc Statistical Software version 17.6 (MedCalc Software) and GraphPad Software (GraphPad Software, Inc) were used for statistical analysis. Results: Of the 349 patients with wet AMD, 192 were included in the study (55%). Of these, 47 (24.5%) developed wet AMD in the fellow eye. The average time to second-eye conversion was 2.6 years, with fellow-eye conversion more likely to occur after 2 years of unilateral disease. On average, patients received 2.16 fewer injections per year in the fellow eye compared with the initially diagnosed eye ( P = .03), and fellow eyes tended to have better OCT results after 12 months of treatment. In addition, compared with ranibizumab and bevacizumab, aflibercept injections appeared to improve visual acuity both in initially diagnosed and fellow eyes. Conclusions: Exudative AMD in the fellow eye has a decreased treatment burden and better visual outcomes compared with the initial eye, which may be attributed to more frequent surveillance and early diagnosis.

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Ranibizumab treatment for neovascular age-related macular degeneration in patients with good baseline visual acuity (better than 6/12): 12-month outcomes

British Journal of Ophthalmology ◽

10.1136/bjo.2009.174763 ◽

2010 ◽

Vol 94 (11) ◽

pp. 1543-1545 ◽

Cited By ~ 9

Author(s):

M. S. A. Raja ◽

M. Saldana ◽

C. Goldsmith ◽

B. J. L. Burton

Keyword(s):

Visual Acuity ◽

Macular Degeneration ◽

Age Related Macular Degeneration ◽

Age Related ◽

Better Than ◽

Baseline Visual Acuity ◽

Ranibizumab Treatment

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Socioeconomic status and visual outcome in patients with neovascular age-related macular degeneration

European Journal of Ophthalmology ◽

10.1177/1120672120920783 ◽

2020 ◽

pp. 112067212092078

Author(s):

Nadav Levinger ◽

Gala Beykin ◽

Michelle Grunin ◽

Diego Almeida ◽

Jaime Levy ◽

...

Keyword(s):

Socioeconomic Status ◽

Optical Coherence Tomography ◽

Visual Acuity ◽

Macular Degeneration ◽

Medical Information ◽

Visual Outcome ◽

Age Related Macular Degeneration ◽

Optical Coherence ◽

Age Related ◽

Baseline Visual Acuity

Purpose Visual outcome in patients with neovascular age-related macular degeneration is variable. We aimed to evaluate for association between socioeconomic status visual acuity in neovascular age-related macular degeneration. Methods A retrospective single-center study of a consecutive group of neovascular age-related macular degeneration patients was performed. Socioeconomic status was determined for each patient based on the 2008 Israeli census. Medical information was extracted from medical records and included visual acuity and optical coherence tomography parameters. Associations between socioeconomic status and clinical outcomes were analyzed. Results A total of 233 patients were included in the analysis. A correlation was found between low baseline visual acuity of the first eye diagnosed with neovascular age-related macular degeneration and low socioeconomic status (r = −0.13, p = 0.049; n = 233). The difference between the visual acuity of the lowest and the highest socioeconomic status categories at baseline was approximately 3 ETDRS lines (p = 0.048). Socioeconomic status and baseline visual acuity of the second eye of the same individual with neovascular age-related macular degeneration were not correlated (r = −0.05, p = 0.95). Socioeconomic status was not associated with the number of anti-vascular endothelial growth factor injections of the first or second eye, or the visual acuity outcome of the first or second eye after 1 year of therapy (p = 0.421, p = 0.9, respectively). Central subfield thickness of the first eye at presentation as measured by spectral-domain optical coherence tomography was associated with socioeconomic status (r = −0.31 p = 0.001). Conclusion Individuals of lower socioeconomic status presented at more advanced stage of the disease when developing neovascular age-related macular degeneration in the first eye but not in the second eye. The research underscores the importance of improving referral patterns and awareness for the lowest socioeconomic status classes.

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