First Author: K.Kortuem GERMANY
Co Author(s): C. Kern R. Liegl W. Mayer B. Schworm S. Priglinger M. Mueller
Back to previous
The purpose of this study was to investigate the average change of visual acuity in patients with neovascular age-related macular degeneration (nAMD) being treated with intravitreal Aflibercept (IVT-AFL) after 12 months.
Retrospective, unblinded, non-randomized monocentric database cohort study in a German academic eye hospital.
Patients diagnosed with nAMD as seen in OCT and fluorescein angiography. Patients were treated with 2 mg IVT-AFL according to European IVT-AFL product labeling (3 monthly loading doses followed by bi-monthly injections). Data was extracted from the smart eye database of Munich’s University Eye Hospital, which currently includes more than 330,000 patients with clinical data (e.g. visual acuity, intraocular pressure), diagnoses (ICD-10) and measurement data from devices like Spectralis OCT. For each visit, visual acuity was acquired. Statics were done using “R” software.
113 patients with 125 treated eyes (64 female eyes, average age: male 74.1, female: 73.2) were included in the study. Within the first year of therapy, patients received a mean number of 5.9 injections (standard deviation ± 2.3). Within the first 100 days, the mean number of injections was 3.06, between 100 and 360 days after start of treatment the mean number of injections was 3.2. Visual acuity at start of treatment was 0.739 LogMAR. After 30 days, the median improvement was -0.03 (SD 0.225) LogMAR, after 180 days of -0.11 LogMAR (SD 0.381) and after 360 days of -0.105 LogMAR (SD 0.424). One line of visual acuity was gained in 29 eyes, 2 lines were gained in 16 eyes and 3 or more lines were gained in 9 eyes.
In average, one line of VA was gained. Most patients experienced a visual acuity gain under AFL therapy. This confirms other real-life studies. However, in comparison to randomized clinical trials, the gain in this study was not as distinct. The mean number of injections were less compared to clinical trials and label. It is therefore recommendable to follow-up patients intensively and tie them closely to the medical retina clinic. Further studies need to be conducted, to find out the reason for fewer injections. Improvement of patient adherence might be achieved by applying a treat and extend treatment regime, which often leads to an increase in the number of injections while reducing the total number of visits and thereby reducing the burden of therapy for patients.