First Author: R.Manrique Lipa SPAIN
Co Author(s): M. Asencio Duran J. Abelairas Gomez C. Hijar Ordovas
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To describe visual outcomes in patients with neovascular age-related macular degeneration (AMD) treated with anti-VEGF intravitreal injections and baseline poor visual acuity.
Ophthalmology Department. Hospital Santa Barbara, Soria, Spain.
Retrospective, observational study. Fifty six naïve patients older than 50 years old with exudative AMD treated with anti-VEGF injections with a follow up at least one year and initial best corrected visual acuity (BCVA) worse than 0,1 (decimal) or equivalent > +1,0 LogMAR were included. A complete medical and ophthalmology data were recorded, which included: age, gender, baseline and final visual acuity, changes in BCVA (improvement +0,3 LogMAR, worsen -0,3 LogMAR, and no changes), central macular thickness and optical coherence tomography (OCT) characteristics.
Time of follow-up was 26 months (12-67 months). Mean baseline BCVA was +1,6 LogMAR and final BCVA was +1,5 LogMAR, difference no significant (p=0,07). In 19 eyes (33,9%) baseline BCVA was < +1,3 LogMAR, in which the mean final BCVA was +1,2 LogMAR ; in 37 eyes (66,1%) baseline BCVA were > +1,3 LogMAR, in which the mean final BCVA was +1,6 LogMAR, difference significant (p=0,001). Likewise, of cases with baseline BCVA < +1,3 LogMAR, 13 cases (63,2%) maintained o improved final BCVA. On the contrary, of cases with baseline BCVA > +1,3 LogMAR, 29 eyes (79,8%) maintained or worsened final BCVA. Mean central retinal thickness decreased from 359um ± 126um to 298um ± 122um (p=0,002). Of all cases, improvement (+0,3 LogMAR) was found in 13 patients (20%), worsening (-0,3 LogMAR) in 7 patients (10,3%) and no changes in BCVA were found in 36 patients (53%). In multivariate analysis, final BCVA was predicted by baseline BCVA and inversely to baseline central macular thickness (thicker macula, better vision).
Patients with neovascular AMD and low visual acuity (<0.1 decimal) benefit from anti-VEGF intravitreal injections. More than half of patients maintain baseline BCVA and one fifth improve baseline visual acuity. Patients with a baseline BCVA < +1,3LogMAR improve significantly compared to > +1,3 LogMAR during follow up. Final BCVA could be predicted by baseline BCVA and baseline central macular thickness.