Long term outcomes in a real life setting treatment by anti‐vascular endothelial growth factor for wet age‐related macular degeneration

Abstract

PurposeTo report long‐term visual outcomes for patients receiving a real life setting treatment by anti‐vascular endothelial growth factor (VEGF) for neovascular age‐related macular degeneration (AMD).MethodsRetrospective chart review of 500 patients who received a first anti‐VEGF injection for wet AMD from January 1, 2006 to January 1, 2010 at the Quinze‐Vingts National Hospital (Paris). Patients clinical characteristics, ETDRS letter score at baseline, every years and at the last follow‐up were recorded. The number of injections and the date of the first and last injection were also recorded. The main outcome measure was mean change in letter score at 5, 6 and 7 years from baseline.Results150 eyes of 120 patients with at least 5 years of follow‐up were identified. The eyes non‐selected had an insufficient follow‐up or another macular disease treated by anti‐VEGF. The mean follow‐up was of 77 months. Mean change in letter score at 5, 6 and 7 years was respectively + 2 letters, ‐1 letters and ‐ 4 letters. A vision of 20/40 or better was achieved in 20% of treated eyes. Seventy percent of eyes was untreated since 6 months or more at the last follow‐up. Patients received an average of 4 injections per year.ConclusionsReal life setting treatment of neovascular AMD by anti‐VEGF results in a stabilization of vision at 5 and 6 years of treatment. At the seventh years of follow‐up, visual outcomes tend to be worse. Mean duration of treatment was 46 months, with 70% patient no longer requiring reinjection after a mean of 34 months after initiation. Evolution of treatment settings suggests that visual outcomes would be better for recently diagnosed and treated patients.