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Treatment of neovascular age‐related macular degeneration with anti‐VEGF agents: predictive factors of long‐term visual outcomes
Author(s) -
Pedrosa A.C.,
Sousa T.,
PinheiroCosta J.,
Beato J.,
Falcão M.,
FalcãoReis F.,
Carneiro Â.
Publication year - 2016
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2016.0498
Subject(s) - medicine , macular degeneration , visual acuity , ophthalmology , choroidal neovascularization , diabetic retinopathy , retrospective cohort study , ranibizumab , retinal , surgery , bevacizumab , diabetes mellitus , chemotherapy , endocrinology
Purpose To evaluate the predictive factors of long‐term visual outcomes in neovascular age‐related macular degeneration (nAMD) treated with anti‐VEGF agents. Methods Unicentric retrospective review of patients with nAMD treated with anti‐VEGF agents. Visual outcomes, 12 and 60 months after diagnosis, were evaluated: visual acuity (VA), VA variation, VA ≥65 ETDRS letters and VA variation >0 ETDRS letters. In the attempt to identify predictive factors of visual outcomes, the following variables were analyzed: at baseline, age, gender, VA, choroidal neovascularization subtype, central foveal thickness, presence of subfoveal hemorrhage or fibrosis, and treatment delay; during follow‐up, frequency of medical examinations, missed medical examinations, intravitreal injections, missed injections and of treatment suspension, as well as the development of retinal atrophy, subretinal fibrosis, sudden massive retinal hemorrhage and retinal pigment epithelium tear. Results One hundred and seventeen patients were included. In multivariate analysis, the only predictive factor of visual outcomes at 12 months was baseline VA: a higher baseline VA was associated with a higher final VA and a higher likelihood of final VA ≥65 ETDRS letters, but a smaller VA variation and a lower likelihood of VA increase. Baseline VA remained a predictive factor of all visual outcomes 60 months after diagnosis. Additionally, at 60 months, higher final VA was also predicted by a higher number of injections and no subretinal fibrosis during follow‐up, and VA increase was more frequent in younger and female patients. Conclusions Baseline VA influences absolute VA and VA variation at 12 and 60 months, while number of injections, development of subretinal fibrosis, age at diagnosis and gender are predictive factors at 60 months.