Number of injections ‘key’ to sustaining vision in wet AMD
KOLOA, Hawaii — Although the number of injections varies among patients with neovascular age-related macular degeneration, receiving at least one improves visual acuity, according to a speaker at Retina 2020.
In long-term studies, patients treated with ranibizumab have demonstrated increases in visual acuity, which then slowly decrease, but still remain better or similar to baseline, Sophie J. Bakri, MD, professor of ophthalmology, vitreoretinal diseases and surgery at Mayo Clinic, said.
About 40% to 80% of patients with wet AMD develop geographic atrophy, most have residual fluid seen on OCT, and over time, choroidal neovascularization lesion size increases. However, half of patients maintain a visual acuity of 20/40 or better despite variable number of injections, she said.
Visual acuity correlates with the number of injections given. Patients who had at least one injection had better visual acuity and those who had no injections lost visual acuity, according to Bakri.
“The reason why [patients] weren’t getting more injections was because they weren’t doing well in the first place,” she said. “This is definitely an issue when interpreting these long-term studies.”
Loss to follow-up is also an issue with these long-term studies, according to Bakri.
“The number of injections is key to maintaining vision, but we have to be careful with how we interpret the number of injections,” Bakri said. – by Alaina Tedesco
Reference: Bakri SJ. What have long-term AMD Studies taught us on nAMD management? Presented at: Retina 2020; Jan. 19-24, 2020; Koloa, Hawaii.
Disclosure: Bakri reports being a consultant for Alimera, Allegro, Allergan, EyePoint, Kala, Genentech, Roche and Novartis, and receiving research funding from Lowy Medical Foundation and NEI/NIH.