Real-World Visual And Clinical Outcomes For Patients With Neovascular Age-Related Macular Degeneration Treated With Intravitreal Ranibizumab: An 8-Year Observational Cohort (AMD8)

• Main Authors: Horner F, Lip PL, Clark H, Chavan R, Sarmad A, Mushtaq B
• Format: Article
• Language: English
• Published: Dove Medical Press 2019-12-01
• Series: Clinical Ophthalmology
• Subjects: age-related macular degeneration; ranibizumab; real-world; 8 year
• Online Access: https://www.dovepress.com/real-world-visual-and-clinical-outcomes-for-patients-with-neovascular--peer-reviewed-article-OPTH
• ISSN: 1177-5483

Faye Horner, Peck-Lin Lip, Hannah Clark, Randhir Chavan, Ambreen Sarmad, Bushra Mushtaq Birmingham and Midland Eye Centre, Birmingham, UKCorrespondence: Bushra MushtaqBirmingham and Midland Eye Centre, City Hospital, Dudley Road, Birmingham B18 7QH, UKEmail [e-mail]: To report the long-term clinical outcomes for patients with neovascular age-related macular degeneration (nAMD) who received anti-vascular endothelial growth factor (anti-VEGF) therapy as part of a standardised treatment protocol in a real-world setting.Patients and methods: This is a retrospective audit of all treatment-naïve patients with nAMD who commenced a pro re nata (PRN) treatment regimen of intravitreal Ranibizumab from January to December 2009 and completed 8 years of follow-up in one single-treatment centre. Electronic medical notes were reviewed to evaluate the outcome measures. Outcome measures included progression of visual acuity (VA), central retinal thickness (CRT) and treatment frequency.Results: 95 eyes from 86 patients had complete data for 8 years of follow-up. Baseline median CRT was 295μm [IQR 254–349] and improved to 209μm [IQR 182–254] in year 8 (p<0.001); baseline median VA was 61 ETDRS letters which increased to 70 letters post-loading however was reduced to 55 letters by year 8 (mean VA change from baseline was −9.1 letters); 47.4% had stable or improved vision, 10.5% gained ≥15 letters and 33.7% had lost ≥15 letters. The highest visual gain was achieved after the initial loading-phase, with a subsequent steady decline, 26.3% (compared to baseline 33.4%) achieved driving vision standard. Median injection frequency was 6 (range 3–10) in year 1 and 3 injections (range 0–10) in year 8. 51.6% of eyes required at least one injection each year and only 34.7% required no injections in year 8.Conclusion: Our real-world nAMD treatment cohort using Ranibizumab PRN regimen achieved an encouraging almost 50% stable or improved VA at year 8 and total injections of 31.6 injections per patient over an 8-year period.Keywords: age-related macular degeneration, Ranibizumab, real-world, 8 year