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Purpose: To analyze the long-term visual outcomes of vascular endothelial growth factor inhibitors in treatment-naïve eyes with neovascular age-related macular degeneration (AMD). Methods: Retrospective study with 48 eyes of 44 treatment-naïve patients with neovascular AMD treated only with anti-angiogenic. Visual acuity (VA) results were analyzed after 6 months and 1, 3, and 5 years of follow-up. Results: Mean VA improved from 61.04 to 65.83 letters after 6 months, with a loss of −1.14, −16.88 and −27.50 letters compared to baseline after 1, 3 and 5 years. The proportion of eyes that lost < 15 letters at 3 and 5 years was 50% and 33.3%, respectively. The proportion of eyes with a gain of > 15 letters was 14.6% and 12.5% at 3 and 5 years. The proportion of eyes with a VA > 70 letters was 41.7% at baseline and 22.92% and 10.42% after 3 and 5 years. The mean number of injections received was 4.81, 2.21, 1.73, 1.17 and 0.9 at years 1, 2, 3, 4, and 5, respectively, and the mean number of visits was 7.19, 4.88, 4.02, 3.40, and 2.85. Older age, lower VA at baseline and pseudophakic eyes showed worse long-term visual outcomes. Conclusions: The visual outcomes of this study are inferior compared to previous studies. Nevertheless, the number of injections received was lower, and all eyes completed a 5-year follow-up.

Treatment of exudative age-related macular degeneration with anti-angiogenic drugs: analysis of long-term visual function in routine clinical practice