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.

The Author(s). Published by S. Karger AG, Basel

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