Journal
RETINA-THE JOURNAL OF RETINAL AND VITREOUS DISEASES
Volume 41, Issue 1, Pages 118-124Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/IAE.0000000000002798
Keywords
bilateral age-related macular degeneration; real-world outcomes; registry; neovascular; vascular endothelial growth factor inhibitor; 5 years incidence of bilateral age-related macular degeneration
Categories
Funding
- Royal Australian NZ College of Ophthalmologists Eye Foundation (2007-2009)
- National Health and Medical Research Council, Australia (NHMRC 2010-2012)
- Macular Disease Foundation, Australia
- NHMRC practitioner fellowship
- Walter and Gertrud Siegenthaler Foundation Zurich, Switzerland
- Swiss National Foundation
- Novartis
- Bayer
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The study compared treatment intensity and visual acuity gains for first- and second-affected eyes with age-related macular degeneration over 5 years. It found that second-affected eyes had higher visual acuity gains but received fewer treatments and reactivated earlier. Care should be taken to avoid undertreating second-affected eyes.
Purpose: To compare treatment intensity and mean visual acuity gains for first- and second-affected eyes with age-related macular degeneration nAMD over 5 years of treatment. The cumulative incidence of second-eye involvement was assessed. Method: We analyzed data from the Fight Retinal Blindness! project database, a prospectively designed registry of real-world outcomes from Australia, New Zealand, Switzerland, and Singapore. Patients with bilateral age-related macular degeneration with >= 5 years of follow-up on treatment were included. Results: Six thousand five hundred and forty-two eyes being treated for age-related macular degeneration were tracked from 2005 to 2017. Thousand two hundred and sixty-one patients had bilateral age-related macular degeneration; of whom, 302 had 5 years of follow-up. Of these, 170 patients started treatment for each eye at least 2 months apart. The mean baseline visual acuity of second-affected eyes was significantly higher than that of first-eyes (20/50 + 2 vs. 20/80; P < 0.01). Second-affected eyes lost a mean of 5.8 (-9.1 to -2.6) logarithm of the minimum angle of resolution letters after 5 years of treatment, whereas the vision of the first-affected eyes remained stable (P = 0.01). Second-affected eyes received fewer injections than the first-affected eyes after the first year of treatment (6.2/year vs. 7.8/year; P < 0.01) and reactivated earlier (376 vs. 507 days; P = 0.04). The cumulative incidence of second eye involvement was 54% over 5 years. Conclusion: Second-affected eyes received fewer treatments and reactivated earlier. Care should be taken to avoid undertreating second-affected eyes.
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