Factors for Visual Acuity Improvement After Anti-VEGF Treatment of Wet Age-Related Macular Degeneration in China: 12 Months Follow up

Abstract

Purpose: To evaluate the treatment solutions and effectiveness of intravitreal ranibizumab (RBZ) or conbercept in patients with wet age-related macular degeneration (wAMD) in a real-life setting in China.Methods: The medical records of 368 patients with wAMD who started RBZ or conbercept treatment between 1 May 2014 and 30 April 2018 were evaluated. All patients were defined on fundus angiography at baseline to determine the subtype of AMD (PCV or CNV). We report visual acuity (VA) and central retinal thickness (CRT) measurements at baseline and 12 months.Results: The average number of anti-VEGF injections was 2.1 ± 1.2. The BCVA improvement of these two groups was similar with a difference of 1.00 letter (95% CI: −1.4~3.4, p = 0.8505). At the end of the study, a BCVA increase of at least 5 letters was determined to be a satisfactory efficacy endpoint. Several factors were related to the possible improvement in the satisfactory efficacy endpoint, including female sex (OR 2.07, 95% CI 1.22~3.51), number of injections (OR 1.40, 95% CI 1.12~1.75) and VA change at the first month (OR 13.75, 95% CI 7.41~25.51). Additionally, some factors were related to the possible reduction in the satisfactory efficacy endpoint, including diabetes (OR 0.27, 95% CI 0.10~0.73) and disease history (OR 0.75, 95% CI 0.57~0.98).Conclusion: Our study demonstrates that anti-VEGF drugs can effectively improve BCVA and reduce CRT in AMD patients. Sex, number of injections, VA change at the first month, diabetes and disease history are the most important factors affecting visual acuity.

Retinal layers changes in patients with age-related macular degeneration treated with intravitreal anti-VEGF agents

“…Our findings about the layer changes were in accordance with previous studies, elaborating improved visual acuity and reduced retinal thickness in whole or individual layers following treatment with anti-VEGF agents [ 12 , 22 , 30 ]. It is worth mentioning that previous clinical studies on retinal alterations after intravitreal injection of anti-VEGF mainly reported changes in NFL or GCL-IPL evaluated by OCT [ 23 , 24 , 31 ], just with a relatively small sample size as well [ 32 ].…”

Determination of Vascular Endothelial Growth Factor-B Concentrations in Aqueous Humor and Plasma of Neovascular Age-Related Macular Degeneration and Polypoidal Choroidal Vasculopathy Patients Before and After Anti-VEGF Therapy

“…We speculated that it might be limited by the small sample size, and larger sample sizes in further research might amplify statistical differences significantly. In the present study, the decrease in CRT in both groups proved to be effective for the treatment with anti-VEGF drugs, consistent with previous studies [32][33][34]. At the same time, the CRT had significantly statistical difference between the nAMD group and PCV group at baseline, and the CRT in nAMD remained thinner than in PCV after treatment; thus, we hypothesized that CRT might help to distinguish PCV from nAMD.…”

How do research participants with age-related vision loss talk about their experiences? A secondary discourse analysis of published qualitative extracts

“…However, two studies were conducted in China (Bian et al, 2018(Bian et al, , 2019. These studies both explicitly attest to the importance of family support, as well as concern about how AMD may impact both the individual and their wider family; not only emotionally, but also financially in a context where patients formerly paid for injection treatments for wet AMD, prior to 2019 when medical insurance was extended to cover wet AMD treatment in China (Lu et al, 2021). In this context, constructions of loss of independence and the person with AMD as a burdenaligning with constructions found in studies conducted in other countries where AMD injections are free at the point-of-use or covered by medical insurancemay be informed not only by societal discourses but also by more material, economic concerns.…”