Correlation of Baseline Visual Acuity with Outcomes of Treatment with Anti-VEGF in Neovascular Age-Related Macular Degeneration

Balaji Veluswamy, Andy Lee, Rukhsana G Mirza, Manjot K Gill Northwestern University, Feinberg School of Medicine, Chicago, IL, USACorrespondence: Manjot K Gill Tel +1 312 908-8152Fax +1 312 503-8152Email mgill@nm.orgPurpose: Neovascular age-related macular degeneration (nv-AMD) is the leading cause...

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Autores principales:	Veluswamy B, Lee A, Mirza RG, Gill MK
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	[vision anti-vegf therapy amd] Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/be5a9a16595c4518966869507061af43
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spelling	oai:doaj.org-article:be5a9a16595c4518966869507061af432021-12-02T11:15:53ZCorrelation of Baseline Visual Acuity with Outcomes of Treatment with Anti-VEGF in Neovascular Age-Related Macular Degeneration1177-5483https://doaj.org/article/be5a9a16595c4518966869507061af432020-06-01T00:00:00Zhttps://www.dovepress.com/correlation-of-baseline-visual-acuity-with-outcomes-of-treatment-with--peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Balaji Veluswamy, Andy Lee, Rukhsana G Mirza, Manjot K Gill Northwestern University, Feinberg School of Medicine, Chicago, IL, USACorrespondence: Manjot K Gill Tel +1 312 908-8152Fax +1 312 503-8152Email mgill@nm.orgPurpose: Neovascular age-related macular degeneration (nv-AMD) is the leading cause of blindness in individuals 55 years and older. The advent of anti-vascular endothelial growth factor (anti-VEGF) therapy has greatly altered the visual acuity (VA) prognosis in these patients. While many studies have described treatment outcomes, few have explored the impact of early detection on VA outcomes.Patients and Methods: This retrospective cohort study consisted of treatment-naïve eyes with nv-AMD (ICD9 diagnosis code 362.52) that were treated with bevacizumab, ranibizumab, and aflibercept by four physician investigators in a large urban tertiary center from March 2008 to October 2015. Eyes were categorized by baseline VA into good (20/50 or better), intermediate (20/50– 20/200), and poor (20/200 or worse) initial VA. VA and optical coherence tomography (OCT) findings were evaluated throughout the treatment period.Results: 224 eyes were evaluated. Of eyes with good, intermediate, and poor initial VA, 14.1%, 37.2%, and 58.3% showed an increase in 2 or more lines of vision on LogMAR, respectively [p < 0.001], while 71.8%, 40.7%, and 16.7% of eyes had a final VA of 20/50 or better, respectively [p < 0.001]. Average final Snellen VA in eyes with good, intermediate, and poor initial VA was 20/47, 20/96, and 20/277, respectively. Change in VA for good, intermediate, and poor initial VA groups was ΔLogMAR of +0.117, +0.041, and − 0.230, respectively. Of eyes with good, intermediate, and poor baseline VA, 42.3%, 20.9%, and 20.0%, respectively, showed resolution of fluid on OCT [p = 0.003].Conclusion: Patients with good initial VA were more likely to maintain good vision and show resolution of fluid on OCT through follow-up. Patients with poor initial VA tended to gain more vision, however, had poorer final VA. This underscores the importance of early detection and treatment of nv-AMD in maintaining superior outcomes.Keywords: vision, anti-VEGF therapy, AMDVeluswamy BLee AMirza RGGill MKDove Medical Pressarticle[visionanti-vegf therapyamd]OphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 14, Pp 1565-1572 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	[vision anti-vegf therapy amd] Ophthalmology RE1-994
spellingShingle	[vision anti-vegf therapy amd] Ophthalmology RE1-994 Veluswamy B Lee A Mirza RG Gill MK Correlation of Baseline Visual Acuity with Outcomes of Treatment with Anti-VEGF in Neovascular Age-Related Macular Degeneration
description	Balaji Veluswamy, Andy Lee, Rukhsana G Mirza, Manjot K Gill Northwestern University, Feinberg School of Medicine, Chicago, IL, USACorrespondence: Manjot K Gill Tel +1 312 908-8152Fax +1 312 503-8152Email mgill@nm.orgPurpose: Neovascular age-related macular degeneration (nv-AMD) is the leading cause of blindness in individuals 55 years and older. The advent of anti-vascular endothelial growth factor (anti-VEGF) therapy has greatly altered the visual acuity (VA) prognosis in these patients. While many studies have described treatment outcomes, few have explored the impact of early detection on VA outcomes.Patients and Methods: This retrospective cohort study consisted of treatment-naïve eyes with nv-AMD (ICD9 diagnosis code 362.52) that were treated with bevacizumab, ranibizumab, and aflibercept by four physician investigators in a large urban tertiary center from March 2008 to October 2015. Eyes were categorized by baseline VA into good (20/50 or better), intermediate (20/50– 20/200), and poor (20/200 or worse) initial VA. VA and optical coherence tomography (OCT) findings were evaluated throughout the treatment period.Results: 224 eyes were evaluated. Of eyes with good, intermediate, and poor initial VA, 14.1%, 37.2%, and 58.3% showed an increase in 2 or more lines of vision on LogMAR, respectively [p < 0.001], while 71.8%, 40.7%, and 16.7% of eyes had a final VA of 20/50 or better, respectively [p < 0.001]. Average final Snellen VA in eyes with good, intermediate, and poor initial VA was 20/47, 20/96, and 20/277, respectively. Change in VA for good, intermediate, and poor initial VA groups was ΔLogMAR of +0.117, +0.041, and − 0.230, respectively. Of eyes with good, intermediate, and poor baseline VA, 42.3%, 20.9%, and 20.0%, respectively, showed resolution of fluid on OCT [p = 0.003].Conclusion: Patients with good initial VA were more likely to maintain good vision and show resolution of fluid on OCT through follow-up. Patients with poor initial VA tended to gain more vision, however, had poorer final VA. This underscores the importance of early detection and treatment of nv-AMD in maintaining superior outcomes.Keywords: vision, anti-VEGF therapy, AMD
format	article
author	Veluswamy B Lee A Mirza RG Gill MK
author_facet	Veluswamy B Lee A Mirza RG Gill MK
author_sort	Veluswamy B
title	Correlation of Baseline Visual Acuity with Outcomes of Treatment with Anti-VEGF in Neovascular Age-Related Macular Degeneration
title_short	Correlation of Baseline Visual Acuity with Outcomes of Treatment with Anti-VEGF in Neovascular Age-Related Macular Degeneration
title_full	Correlation of Baseline Visual Acuity with Outcomes of Treatment with Anti-VEGF in Neovascular Age-Related Macular Degeneration
title_fullStr	Correlation of Baseline Visual Acuity with Outcomes of Treatment with Anti-VEGF in Neovascular Age-Related Macular Degeneration
title_full_unstemmed	Correlation of Baseline Visual Acuity with Outcomes of Treatment with Anti-VEGF in Neovascular Age-Related Macular Degeneration
title_sort	correlation of baseline visual acuity with outcomes of treatment with anti-vegf in neovascular age-related macular degeneration
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/be5a9a16595c4518966869507061af43
work_keys_str_mv	AT veluswamyb correlationofbaselinevisualacuitywithoutcomesoftreatmentwithantivegfinneovascularagerelatedmaculardegeneration AT leea correlationofbaselinevisualacuitywithoutcomesoftreatmentwithantivegfinneovascularagerelatedmaculardegeneration AT mirzarg correlationofbaselinevisualacuitywithoutcomesoftreatmentwithantivegfinneovascularagerelatedmaculardegeneration AT gillmk correlationofbaselinevisualacuitywithoutcomesoftreatmentwithantivegfinneovascularagerelatedmaculardegeneration
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Correlation of Baseline Visual Acuity with Outcomes of Treatment with Anti-VEGF in Neovascular Age-Related Macular Degeneration

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