Lanzetta, Paolo;
Cruess, Alan F.;
Cohen, Salomon Y.;
Slakter, Jason S.;
Katz, Todd;
Sowade, Olaf;
Zeitz, Oliver;
Ahlers, Christiane;
Mitchell, Paul
Predictors of visual outcomes in patients with neovascular age‐related macular degeneration treated with anti‐vascular endothelial growth factor therapy: post hoc analysis of the VIEW studies
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Media type:
E-Article
Title:
Predictors of visual outcomes in patients with neovascular age‐related macular degeneration treated with anti‐vascular endothelial growth factor therapy: post hoc analysis of the VIEW studies
Contributor:
Lanzetta, Paolo;
Cruess, Alan F.;
Cohen, Salomon Y.;
Slakter, Jason S.;
Katz, Todd;
Sowade, Olaf;
Zeitz, Oliver;
Ahlers, Christiane;
Mitchell, Paul
Published:
Wiley, 2018
Published in:
Acta Ophthalmologica, 96 (2018) 8
Language:
English
DOI:
10.1111/aos.13751
ISSN:
1755-375X;
1755-3768
Origination:
Footnote:
Description:
<jats:title>Abstract</jats:title><jats:sec><jats:title>Purpose</jats:title><jats:p>Identify predictors for response to anti‐vascular endothelial growth factor (<jats:styled-content style="fixed-case">VEGF</jats:styled-content>) therapy in patients with neovascular (wet) age‐related macular degeneration (<jats:styled-content style="fixed-case">nAMD</jats:styled-content>).</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Retrospective, <jats:italic>post hoc</jats:italic> analysis of <jats:styled-content style="fixed-case">VIEW</jats:styled-content> 1/2. Patients were randomized 1:1:1:1 to 0.5 mg intravitreal aflibercept (<jats:styled-content style="fixed-case">IVT</jats:styled-content>‐<jats:styled-content style="fixed-case">AFL</jats:styled-content>) injection every 4 weeks (0.5q4); 2 mg <jats:styled-content style="fixed-case">IVT</jats:styled-content>‐<jats:styled-content style="fixed-case">AFL</jats:styled-content> every 4 weeks (2q4); 2 mg <jats:styled-content style="fixed-case">IVT</jats:styled-content>‐<jats:styled-content style="fixed-case">AFL</jats:styled-content> every 8 weeks (2q8) after an initial three injections at weeks 0, 4 and 8 or 0.5 mg intravitreal ranibizumab every 4 weeks (0.5q4).</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>1815 patients [<jats:styled-content style="fixed-case">IVT</jats:styled-content>‐<jats:styled-content style="fixed-case">AFL</jats:styled-content> 2q4 (<jats:italic>n </jats:italic>=<jats:italic> </jats:italic>613); <jats:styled-content style="fixed-case">IVT</jats:styled-content>‐<jats:styled-content style="fixed-case">AFL</jats:styled-content> 2q8 (<jats:italic>n </jats:italic>=<jats:italic> </jats:italic>607); ranibizumab 0.5q4 (<jats:italic>n </jats:italic>=<jats:italic> </jats:italic>595)] were included. Baseline demographics/characteristics were evenly balanced. Younger age (49–69 years), lower visual acuity (<jats:styled-content style="fixed-case">VA</jats:styled-content>) [10.0–≤45.0 Early Treatment Diabetic Retinopathy Study (<jats:styled-content style="fixed-case">ETDRS</jats:styled-content>) letters] and smaller choroidal neovascularization (<jats:styled-content style="fixed-case">CNV</jats:styled-content>) size [0.0–≤3.1 disc areas (<jats:styled-content style="fixed-case">DA</jats:styled-content>)] at baseline were associated with the most vision gain (≥15 letters) over 52 weeks (all nominal p < 0.0001).Younger age, higher baseline <jats:styled-content style="fixed-case">VA</jats:styled-content> (>64.0–≤83.0 letters) and smaller <jats:styled-content style="fixed-case">CNV</jats:styled-content> size were associated with a <jats:styled-content style="fixed-case">VA</jats:styled-content> ≥20/40 at week 52. Predominantly classic <jats:styled-content style="fixed-case">CNV</jats:styled-content> at baseline (nominal p = 0.0007), older age (≥90 years), lower baseline <jats:styled-content style="fixed-case">VA</jats:styled-content> (10.0–≤ 45.0 <jats:styled-content style="fixed-case">ETDRS</jats:styled-content> letters) and larger <jats:styled-content style="fixed-case">CNV</jats:styled-content> size (>10.1–≤32.6 <jats:styled-content style="fixed-case">DA</jats:styled-content>) were all associated with a <jats:styled-content style="fixed-case">VA</jats:styled-content> ≤20/200 at week 52 (all nominal p < 0.0001). Along with treatment (nominal p < 0.0001), lower <jats:styled-content style="fixed-case">VA</jats:styled-content> (p = 0.0166) and smaller central retinal thickness (both nominal p = 0.0190) were predictors for dry retina development.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Younger age, lower VA and smaller <jats:styled-content style="fixed-case">CNV</jats:styled-content> size at baseline were all associated with greater vision gains over 52 weeks while younger age, higher <jats:styled-content style="fixed-case">VA</jats:styled-content> and smaller <jats:styled-content style="fixed-case">CNV</jats:styled-content> size at treatment start were more likely to achieve best‐corrected VA 20/40 or better after a year's treatment, suggesting the benefit of early anti‐<jats:styled-content style="fixed-case">VEGF</jats:styled-content> treatment.</jats:p></jats:sec>