What about the fellow eye in treatment of neovascular age-related macular degeneration? Analysis of data from the Swedish macula register

Purpose To analyse the development of neovascular age-related macular degeneration (nAMD) in the fellow eye in patients initially presenting with unilateral nAMD, using data from the Swedish Macula Register. Methods This observational study included data on treatment-naive patients who initially underwent unilateral treatment for nAMD, and then required bilateral treatment, between 2010 and 2018, according to the Swedish Macula Register (SMR). The data were also stratified according into three time periods (2010-2013; 2014-2016; 2017-2018). Treatment duration, best-corrected visual acuity (BCVA) in the first and second eye, number of injections in the first eye before falling ill in the second, and the time between the last injection in the first eye and the start of treatment of the fellow eye were analysed. Results 5216 out of 28 670 (18%) patients treated for nAMD subsequently required bilateral treatment. The mean age was 77.7 +/- 7.3 years, and 69% were female. The mean duration of treatment of the first eye before nAMD was diagnosed in the fellow eye was 1.58 years, and the mean number of injections in the first eye was 8.9 +/- 8.6. Best-corrected visual acuity, according to the ETDRS chart, was higher in the second eye at the time when treatment started in that eye compared to treatment start in the first eye: 62.8 (14.7) versus 57.6 (15.5); p < 0.001, and was higher in the 66% whose first eye was still undergoing treatment: 63.6 +/- 14.5 versus 61.0 +/- 14.8; p = 0.001. Conclusions The mean duration of treatment of the first eye before treatment started in the fellow eye was 19 months, and treatment of the second eye had started within 2 years in 61% of the patients. Best-corrected visual acuity was higher in the second eye than in the first eye at the start of treatment of that eye and was higher in the second eye at the start of treatment of that eye when the first eye was still being treated.

Automated summary

This study analyzed the development of neovascular age-related macular degeneration (nAMD) in the fellow eye of patients initially presenting with unilateral nAMD, using data from the Swedish Macula Register. The results showed that a proportion of patients required bilateral treatment, with treatment of the fellow eye starting within approximately 2 years of the first eye's treatment. Best-corrected visual acuity in the second eye at the start of treatment was generally higher than that of the first eye.