Lapse in care may yield lost visual acuity in AMD
Patients with neovascular age-related macular degeneration who have a 3 month or longer lapse of anti-VEGF treatment may experience unrecoverable loss of vision, according to a study.
“We saw significant loss of vision, even for those who were initiated back on anti-VEGF therapy after these lapses,” study co-author Rishi P. Singh, MD, told Healio/OSN.
The retrospective study included 241 patients in the study group and 241 control patients. The researchers evaluated macular thickness measured by central subfield thickness (CST) and visual acuity at baseline, at the first post-lapse appointment, and at 3, 6 and 12 months after the lapse.
The average length of lapse in the study group was 5 ± 3.7 months.
Mean best corrected visual acuity (BCVA) at baseline in the control group was 59.2 letters compared with 58.9 letters in the study group. Mean CST at baseline in the control group was 259.8 µm compared with 252.4 µm in the lapse group.
BCVA decreased at each timepoint after lapse in the study group. At 12 months after the lapse, the mean BCVA in the study lapse group was 51.2 ETDRS letters compared with 57.1 letters in the control group. The mean CST at 12 months was 258.8 µm in the lapse group compared with 250.8 µm in the control group.
The loss of visual acuity in the study cohort from baseline to 12 months, 58.9
to 51.2 letters, was a statistically significant decrease (P < .01).
After resumption of anti-VEGF therapy, CST in the lapse cohort normalized through 12 months of follow-up; however, visual acuity loss did not recover.
The study, which was conceived before the pandemic, was aimed at understanding the effect a lapse in treatment has on patients with neovascular AMD, Singh said.
“Obviously with the COVID pandemic this becomes far more relevant. Patients were missing 3 months of therapy because of the pandemic and fear of coming in to see us,” Singh said.