Remission and dropout rate of anti-VEGF therapy for age-related macular degeneration

• Published in: European journal of ophthalmology Vol. 21; no. 6; p. 777
• Main Authors: Oishi, Akio, Mandai, Michiko, Nishida, Akihiro, Hata, Masayuki, Matsuki, Takaaki, Kurimoto, Yasuo
• Format: Journal Article
• Language: English
• Published: United States 01.11.2011
• Subjects: Aged; Angiogenesis Inhibitors - therapeutic use; Antibodies, Monoclonal, Humanized - therapeutic use; Aptamers, Nucleotide - therapeutic use; Combined Modality Therapy; Female; Follow-Up Studies; Humans; Intravitreal Injections; Macular Degeneration - drug therapy; Macular Degeneration - physiopathology; Male; Patient Dropouts - statistics & numerical data; Photochemotherapy; Ranibizumab; Remission Induction; Retrospective Studies; Vascular Endothelial Growth Factor A - antagonists & inhibitors; Visual Acuity - physiology
• ISSN: 1724-6016
• DOI: 10.5301/ejo.2011.7430

Anti-vascular endothelial growth factor (VEGF) therapy is a first-line treatment for age-related macular degeneration (AMD) but frequent visits and injections can be a burden for patients. The purpose of this study is to estimate the remission rate and tolerability of anti-VEGF therapy for AMD in a clinical setting. We investigated 90 eyes of 87 patients with AMD who underwent anti-VEGF therapy and were followed for more than 6 months. Ranibizumab and pegaptanib were used as anti-VEGF agents. Initial therapy was any of the following: a single injection, 3 consecutive monthly injections, or combination therapy with verteporfin. Additional injections were given as-needed during follow-up. An injection-free period greater than 6 months at the final observation was regarded as cessation; the reason for cessation was studied for each patient. Clinical characteristics were compared between patents with and without cessation. The mean follow-up period was 12.8 months. Mean logMAR before and 6 months after the treatment was 0.89 and 0.83, respectively. Cessation was noted in 32 eyes of 31 patients (35.6%). Remission was achieved in 13 (40.6%) of these eyes. The other cases either did not wish to undergo further treatment or dropped out. Poor baseline visual acuity (VA) was associated with cessation. With current anti-VEGF therapy, remission was achieved in a limited number of AMD cases. The high frequency of voluntary cessation warrants consideration of an alternative treatment and/or supportive care for those with poor baseline VA.