Ten-year changes in visual acuity at baseline and at 2 years after treatment in a Japanese population with age-related macular degeneration

Graefes Arch Clin Exp Ophthalmol. 2021 May;259(5):1191-1198. doi: 10.1007/s00417-020-05005-y. Epub 2020 Nov 17.

Abstract

Purpose: We investigated 10-year changes in baseline best-corrected visual acuity (BCVA), as well as functional and anatomical changes at 1 and 2 years after initial treatment, in eyes with treatment-naïve neovascular age-related macular degeneration (nAMD).

Methods: This retrospective, multicenter, case series reviewed patients with treatment-naïve nAMD who underwent initial treatment from 2006 to 2015, using photodynamic therapy (PDT), anti-vascular endothelial growth factor (VEGF), or a combination of PDT and anti-VEGF. BCVA and central retinal subfield thickness (CRST), were measured at baseline and at 1 or 2 years of follow-up.

Results: In total, 3096 eyes of 3096 patients were included from 14 hospitals. Mean BCVA at baseline became significantly better over the 10-year study period (P < 0.001). BCVA at 1 year significantly improved from baseline in patients who underwent initial treatment from 2009 to 2015 (P = 0.001, 2009; P = 0.004, 2010; P = 0.01, 2011; P < 0.001, 2012-2015). BCVA at 2 years significantly improved from baseline in patients who underwent initial treatment from 2012 to 2015 (P < 0.001, 2012; P < 0.001, 2013-2015). CRST at 1 year decreased significantly from CRST at baseline, each year from 2006 to 2015 (P < 0.001, 2006-2015). CRST at 2 years decreased significantly from CRST at baseline, each year from 2006 to 2015 (P = 0.03, 2006; P < 0.001, 2007-2015).

Conclusion: Baseline BCVA with treatment-naïve nAMD tended to become better during the study period. BCVA at 1 year improved in the era of anti-VEGF; BCVA at 2 years improved in patients who underwent initial treatment in 2012 or later; and CRST decreased in each year during the study period.

Keywords: Age-related macular degeneration; Anti-vascular endothelial growth factor; Baseline visual acuity; J-CREST Study group; Photodynamic therapy.

Publication types

  • Multicenter Study

MeSH terms

  • Angiogenesis Inhibitors* / therapeutic use
  • Humans
  • Intravitreal Injections
  • Japan / epidemiology
  • Macular Degeneration* / diagnosis
  • Macular Degeneration* / drug therapy
  • Ranibizumab
  • Retrospective Studies
  • Tomography, Optical Coherence
  • Treatment Outcome
  • Vascular Endothelial Growth Factor A
  • Visual Acuity

Substances

  • Angiogenesis Inhibitors
  • Vascular Endothelial Growth Factor A
  • Ranibizumab