Treatment of Neovascular Age-Related Macular Degeneration with Anti-VEGF Agents: Predictive Factors of Long-Term Visual Outcomes

Pedrosa, Ana Catarina; Sousa, T.; Pinheiro-Costa, João; Beato, João; Falcão, Manuel; Falcão‐Reis, Fernando; Carneiro, Ângela

doi:10.1155/2017/4263017

Cited by 26 publications

(19 citation statements)

References 12 publications

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“…It is suggested that the response to treatment could also be affected by the baseline vision, due to a phenomenon known as the ceiling effect, whereby subjects with a worse baseline BCVA were less likely to lose further vision and subjects with better BCVA were less likely to improve [44, 45]. This has also been observed in large studies, including the MARINA [46] and ANCHOR [47] studies which reported that the baseline BCVA is a strong predictor of treatment response.…”

Section: Discussionmentioning

confidence: 99%

Association of HTRA1 and ARMS2 gene polymorphisms with response to intravitreal ranibizumab among neovascular age-related macular degenerative subjects

et al. 2019

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Background The association of HTRA1 rs11200638 and ARMS2 rs10490924 gene polymorphisms with response to intravitreal ranibizumab therapy among neovascular AMD (nAMD) subjects in Malaysia was determined in this study, followed by the expression of HTRA1 and ARMS2 genes. Results Both single nucleotide polymorphisms (SNPs) recorded a significant association between nAMD and controls with HTRA1 rs11200638 at P = 0.018 (OR = 1.52, 95% CI = 1.07–215) and ARMS2 rs10490924 at P < 0.001 (OR = 2.44, 95% CI = 1.75–3.42). An association was also observed in response to ranibizumab for both SNPs in a logistic regression analysis ( P < 0.001). The mRNA levels in the HTRA1 variant between responder and non-responder groups were significantly different for the homozygous non-risk GG genotype ( P = 0.032). Conclusions The HTRA1 rs11200638 and ARMS2 rs10490924 gene polymorphisms are associated with nAMD among Malaysians. Both gene polymorphisms were also correlated with response to intravitreal ranibizumab therapy based on visual and anatomical outcomes especially the HTRA1 rs11200638 variant.

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Section: Discussionmentioning

confidence: 99%

Association of HTRA1 and ARMS2 gene polymorphisms with response to intravitreal ranibizumab among neovascular age-related macular degenerative subjects

et al. 2019

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“…Neovascular age-related macular degeneration (AMD) is one of the primary causes of visual loss in developed countries [1]. Although the advent of antivascular endothelial growth factor (VEGF) therapy has revolutionized treatment for this condition, the long-term visual outcome is still limited in some patients [2–4].…”

Section: Introductionmentioning

confidence: 99%

Prechoroidal Cleft in Type 3 Neovascularization: Incidence, Timing, and Its Association with Visual Outcome

Kim

Chang

Kim

et al. 2018

Journal of Ophthalmology

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Purpose To investigate the incidence and timing of prechoroidal cleft development and its association with visual prognosis in type 3 neovascularization. Methods This retrospective study included 166 eyes that were diagnosed with type 3 neovascularization. All eyes were treated with antivascular endothelial growth factor therapy. The incidence and timing of prechoroidal cleft development were evaluated. Best-corrected visual acuity (BCVA) at diagnosis and at final follow-up was compared between eyes with (cleft group) and without (no-cleft group) prechoroidal cleft. The incidence of retinal pigment epithelium (RPE) tear and subretinal hemorrhage was also compared between the two groups. Results During the mean 39.7 ± 18.5 months of follow-up, prechoroidal cleft developed in 37 eyes (22.3%) at an average of 14.6 ± 10.4 months. The BCVA at final follow-up was significantly worse in the cleft group than in the no-cleft group (P=0.024), whereas the difference was not significant at diagnosis (P=0.969). The incidence of RPE tear (P=0.002) and subretinal hemorrhage (P < 0.001) was significantly higher in the cleft group. Conclusions Prechoroidal cleft is a frequently observed finding during the treatment course of type 3 neovascularization. Eyes with prechoroidal cleft are at high risk of RPE tear or subretinal hemorrhage and subsequently associated with poor prognosis.

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“… 14 However, in the real-life setting, from which data are reported here, treatment was adjusted to the response, implying that patients with a more modest treatment effect also received more injections. 7 In accordance with this, derived variables, such as the follow-up time and the number of visits, and thereby also the control interval, had no separate influence on the treatment response. The real-life setting implied that all patients were treated, 15 and thus the average therapeutic response was more moderate than in RCTs performed on selected patient materials.…”

Section: Discussionmentioning

confidence: 76%

“…However, with access to large data sets, this lack of homogeneity gives the opportunity to study the contribution of individual risk factors to the outcome of the treatment. A recent study of real-life experience with anti-VEGF treatment in wAMD had a long follow-up, 7 but the study was retrospective, patient selection due to death or discontinuation of follow-up was not accounted for, and the study was powered only for the study of a few variables.…”

Section: Introductionmentioning

confidence: 99%

Age, sex, and type of medication predict the effect of anti-VEGF treatment on central retinal thickness in wet age-related macular degeneration

Bek¹,

Klug²

2018

OPTH

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PurposeRandomized clinical trials studying the effects of VEGF inhibition on wet age-related macular degeneration (wAMD) are designed so that the effects of individually varying risk factors on the treatment response are eliminated. The influence of these risk factors can be studied in large data sets from real-life experience.Patients and methodsAll 2,255 patients diagnosed with wAMD requiring anti-VEGF treatment in at least one eye over more than 9 years in a defined Danish population with 0.9 million inhabitants were studied. The predictive value of eye laterality, sex, current smoking status, type of anti-VEGF compound, membrane position, membrane type, leakage area, number of injections, number of visits, age, time to follow-up, visual acuity, and central retinal thickness (CRT) at baseline on change in CRT after three monthly injections with anti-VEGF compound followed by treatment pro re nata for up to 12 months was assessed.ResultsAfter 12 months, 67 patients had died, 903 had had stable CRT for at least 6 months, and 1,285 patients had not achieved stable CRT. The reduction in CRT was −84.8±118.3 μm, whereas the increase in visual acuity was 2.2±14.7 Early Treatment Diabetic Retinopathy Study letters. The risk factors included contributed to 64% of the variation in CRT reduction. High age and high CRT at baseline predicted high CRT reduction, whereas more injections, treatment with ranibizumab, and male sex predicted a low CRT reduction.ConclusionAge, sex, and type of anti-VEGF medication can be used to plan treatment and inform patients about the expected response of anti-VEGF treatment in wAMD.

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Treatment of Neovascular Age-Related Macular Degeneration with Anti-VEGF Agents: Predictive Factors of Long-Term Visual Outcomes

Cited by 26 publications

References 12 publications

Association of HTRA1 and ARMS2 gene polymorphisms with response to intravitreal ranibizumab among neovascular age-related macular degenerative subjects

Association of HTRA1 and ARMS2 gene polymorphisms with response to intravitreal ranibizumab among neovascular age-related macular degenerative subjects

Prechoroidal Cleft in Type 3 Neovascularization: Incidence, Timing, and Its Association with Visual Outcome

Age, sex, and type of medication predict the effect of anti-VEGF treatment on central retinal thickness in wet age-related macular degeneration

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