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Anti-VEGF treatment patterns of wet age-related macular degeneration (AMD) patients based on presenting visual acuities

Session Details

Session Title: AMD III

Session Date/Time: Sunday 29/09/2013 | 11:00-13:00

Paper Time: 11:56

Venue: Hall G1 (Level 2)

First Author: A.Adegbola UK

Co Author(s):    R. Sivaraj   D. Kinshuck           

Abstract Details

Purpose:

To study the outcomes of patients treated based on their presenting visual acuity including the number of injections needed and their effects on intraocular pressure (IOP). We also looked at retreatment criteria for these patients.

Setting:

Study was conducted in a tertiary Ophthalmology setting in the second largest city in UK

Methods:

We carried out a retrospective analysis of patients receiving treatment for active wet AMD in 2012, using case notes and electronic patient record system (medisoft). Intravitreal Ranibizumab (Lucentis) was the drug used and Optical Coherence Tomography (OCT) imaging was employed. Visual acuities (VA) were documented in LogMAR format. Patients were divided into two groups based on presenting visual acuities of better or worse than 0.5 (6/18)

Results:

79 eyes of 68 patients were looked at. 26 eyes had VA of better than 0.5 and 53 eyes were worse than 0.5. There were 35 right & 44 left eyes. Those with VA better than 0.5 had between 3 – 26 Injections (average 10) and duration of treatment was between 3 to 48 months (average 18 months). Patients with VA worse than 0.5 had 3 – 40 Injections (average 9) and duration of treatment was 3 to 42 months (average 15 months). Retreatment decisions were made based on OCT findings rather than VA. 5/26 patients with VA better than 0.5 developed VA worse than 0.5 with treatment whilst 12/53 patients with baseline VA of 0.5 or less improved to better than 0.5. 2/79 eyes developed increased IOP & 1 eye developed significant cataract.

Conclusions:

Patients (81%) with VA better than 0.5 maintained their VA better than 0.5 after Lucentis injections. 22% of those with VA worse than 0.5, got the VA better than 0.5% after IVL injections. Although individually,28 Lucentis injections was the most number given amongst VA better than 0.5,while 40 is that for the VA worse than o.5. But averagely, eyes with better VA had more injections over a longer period of time than those with worse VA. OCT findings were more influential in determining retreatments rather than VA alone and only 2.5% developed increased IOP. Thus Lucentis injections is more beneficial in treating wet AMD when commenced early and does not significantly affect IOP.

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