Scientific publications
Macular Neovascularization Type Influence on Anti-VEGF Intravitreal Therapy Outcomes in Age-Related Macular Degeneration. Scientific Publication
Jordi Izquierdo-Serra 1 , Ruben Martin-Pinardel 2 , Aina Moll-Udina 1 , Carolina Bernal-Morales 1 , Gonzaga Garay-Aramburu 3 , Jorge Sanchez-Monroy 4 , Carolina Arruabarrena 5 , Ana Fernandez-Hortelano 6 , Marta S Figueroa 7 , Maximino Abraldes 8 , Francisco Javier Lavid de Los Mozos 9 , Miguel Angel Zapata 10 , Jose Maria Ruiz-Moreno 11 , Laura Broc-Iturralde 12 , Jacobo Gonzalez-Guijarro 13 , Jose Juan Escobar-Barranco 14 , Roberto Gallego-Pinazo 15 , Alba Parrado-Carrillo 1 , Marina Dotti-Boada 1 , Socorro Alforja 1 , Marc Figueras-Roca 1 , Daniel Barthelmes 16 , Mark C Gillies 17 , Ricardo P Casaroli-Marano 18 , Javier Zarranz-Ventura 19 ; Writing Committee of the Fight Retinal Blindness Spain (FRB! Spain) Users Group
Purpose: To evaluate the influence of macular neovascularization (MNV) lesion type on 12-month clinical outcomes in treatment-naive eyes with neovascular age-related macular degeneration (nAMD) treated with anti-VEGF drugs nationwide.
Design: Multicenter national nAMD database observational study.
Subjects: One thousand six hundred six treatment-naive nAMD eyes (1330 patients) undergoing anti-VEGF therapy for 12 months nationwide.
Methods: Demographics, visual acuity (VA) in logarithm of the minimum angle of resolution letters, number of injections and visits were was collected using a validated web-based tool. Neovascular lesion phenotype was classified as type 1 (T1, n = 711), type 2 (T2, n = 505), type 3 (T3, n = 315), and aneurysmal type 1 (A-T1, n = 75), according to the new proposed consensus classification.
Main outcome measures: Mean VA change at 12 months, final VA at 12 months, number of injections, time to lesion inactivation.
Results: A total of 1606 treatment-naive nAMD eyes (1330 patients) received a median of 7 injections over 12 months. Mean (± standard deviation) baseline VA was significantly lower for T2 (49.4 ± 23.5 letters) compared with T1 (57.8 ± 20.8) and T3 (58.2 ± 19.4) (both P < 0.05) lesions. Mean VA change at 12 months was significantly greater for A-T1 (+9.5 letters) compared with T3 (+3.1 letters, P < 0.05). Patients with T3 lesions had fewer active visits (24.9%) than those with other lesion types (T1, 30.5%; T2, 32.6%; A-T1, 27.5%; all P < 0.05). Aflibercept was the most used drug in A-T1 lesions (70.1%) and ranibizumab in T1 (40.7%), T2 (57.7%), and T3 (47.6%) lesions.
Conclusions: This study highlights the relevance of MNV type on clinical outcomes in nAMD and reports significant differences in baseline VA, VA change, and lesion activity at 12 months. This report provides data about lesion-specific clinical features, which may guide the management of nAMD cases and potentially support personalized clinical decision making for these patients.
Financial disclosure(s): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
CITATION Ophthalmol Retina. 2024 Apr;8(4):350-359. doi: 10.1016/j.oret.2023.10.022. Epub 2023 Nov 2
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