Is There a Dose-Response Relationship? Real-World Outcomes of Anti-Vascular Endothelial Growth Factor Treatment in Neovascular Age-Related Macular Degeneration

Abstract

Purpose: To explore the dose-response relationship of anti-vascular endothelial growth factor (VEGF) agents, with bevacizumab as 1st line treatment, on visual acuity (VA) outcome during the first year of treatment in neovascular AMD (nAMD) patients in real-life conditions. Methods: A retrospective, observational, single center study at the Ophthalmology Division, Tel Aviv Medical Center. Inclusion criteria was naive AMD patients treated with anti VEGF injections between the years 2017-2020. Electronical medical records (EMRs) were scanned using the MD-Clone software, data from time of diagnosis, containing baseline VA, final VA, number of injections and the injected agent was gathered. Subjects were divided to three groups based on their baseline VA ('good, 'middle' and 'bad'). Results: A total of 672 patients were included. The cohort demonstrated a statistically non-significant correlation with a positive trend between the log transform of the number of annual injections and the change in VA (P=0.145). However, a significant correlation was established within the 'low VA’ group, (P = 0.015). The 'good' and 'middle' VA groups did not reach statistical significance. Baseline VA was the single significant predictor for VA gain within patients with baseline VA of 6/12 or less. Conclusions: A dose-response relationship between anti-VEGF injections and VA outcome was found only for patients with low baseline VA. Individual patient characteristics might need to be included to precise individualized treatment regimen and improve visual outcome.

Transitioning from Aflibercept to Biosimilar Ranibizumab in Neovascular AMD (The TRANSFORM Trial): A Multicenter Observational Study

“…In contrast to our findings, other studies have suggested that there is no correlation between age and number of injections. 20 , 21 …”

“…In contrast to our findings, other studies have suggested that there is no correlation between age and number of injections. 20,21 Further research may be necessary to conclusively determine whether and how age directly affects the number of anti-VEGF injections required to treat AMD.…”

Functional Carbon Quantum Dots for Ocular Imaging and Therapeutic Applications

“…Repeated injections are needed, that often result in low compliance and not all patients respond to the anti-VEGFA treatment. [42][43][44] Furthermore, there is currently no treatment for the dry form of the disease. Therefore, it is essential to develop safe, effective, and long-term treatments for this disease, given its high prevalence.…”