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5 year follow-up of “real life” treatment in neovascular age-related macular degeneration

Session Details

Session Title: AMD I

Session Date/Time: Thursday 17/09/2015 | 08:30-10:30

Paper Time: 09:50

Venue: Athena

First Author: : C.Fonseca PORTUGAL

Co Author(s): :    I. Sobral   N. Oliveira   I. Pires   M. Cachulo   R. Silva  

Abstract Details

PURPOSE:The purpose of this study is to evaluate the 5-year anatomical and functional results of Ranibizumab for the treatment of Neovascular AMD (Age-Related Macular Degeneration) patients, given in an as-needed basis, in real world clinical practice.

Setting:

Ophthalmology Department,Centro Hospitalar e Universitário de Coimbra, Portugal; AIBILI, Association for Innovation and Biomedical Research on Light and Image; Faculty of Medicine, University of Coimbra

Methods:

Retrospective nonrandomized single-center study with 53 eyes of 50 patients and all of them completed 60 months of follow-up. All neovascular AMD patients with signs of active lesions were treated with intravitreal Ranibizumab and followed monthly, at first, with extended intervals later, according to an establish protocol. An extended ophthalmological examination was performed including best corrected visual acuity (BCVA), fundoscopy, spectral domain optical coherence tomography (SD-OCT), fluorescein angiography and, when necessary, indocyanine green angiography, in all patient visits.

Results:

A decrease in visual acuity was observed from baseline (46.2 ETDRS letters) to 60-month visit (43.0 letters), although this difference was not statistically significant. Patients showed a gain of letters in the first (4,0 ±11,7), second (2,6 ±14,3) and third years (1,3 ±18,2) of treatment with subsequent loss afterwards. Patients had a mean number of treatments of 2.2 injections per year. Sixteen patients (30.2%) were still receiving active treatment after 5 years and the main cause for treatment interruption was disease inactivity (64.2%). Treatment duration and initial BCVA were identified as predictors for final BCVA. Peculiarly, total number of treatments was not an independent predictor for final BCVA.

Conclusions:

This work showed that from the third year of follow-up on there is a loss in BCVA. Variables as better initial BCVA and greater duration of treatment seemed to determine better visual long-term outcomes. The main reason for discontinuing treatment was disease inactivity, but after 5 years, almost one-third of all patients is still under treatment for active lesions.

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