First Author: K.Shin SOUTH KOREA
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To evaluate visual changes in patients experienced marked visual deterioration in exudative age-related macular degeneration (AMD) with relatively good initial visual acuity and to investigate causes of visual deterioration.
Among the patients who were diagnosed with exudative AMD and treated with anti-vascular endothelial growth factor (VEGF), patients exhibited 0.5 or better initial visual acuity and 0.1 or worse final visual acuity were included in the retrospective observational study. Patients experienced development of submacular haemorrhage during the follow-up period were included in submacular haemorrhage group. Patients experienced 6 months of longer loss of follow-up and revisited were included in the loss of follow-up group.
Forty-three eyes of 43 patients were included. The mean follow-up period was 43.5±9.4 months. In the submacular haemorrhage group (n = 24), abrupt decrease in visual acuity was noted when the haemorrhage was developed (mean LogMAR (logarithm of minimal angle of resolution) visual acuity: before haemorrhage=0.23±0.09, when the haemorrhage was developed=1.48±0.72, p<0.001). In the loss of follow-up group (n = 6), abrupt decrease in visual acuity was noted when the patients revisited (mean LogMAR visual acuity: before loss of follow-up=0.23±0.10, when the patients revisited=1.63±0.38, p<0.001). In these two groups, the visual acuity failed to completely recover despite additional treatment. The visual acuity was decreased without notable event in the remaining 13 eyes.
The development of submacular haemorrhage and loss of follow-up was found to be factors associated with poor visual prognosis in patients with relatively good initial visual acuity.