Long-Term Outcomes of Nonadherence to Anti-VEGF Therapy in Advanced Neovascular Age-Related Macular Degeneration
https://doi.org/10.18008/1816-5095-2022-3-658-664
Abstract
Purpose: To study long-term outcomes in neovascular age-related macular degeneration (nAMD) patients with low visual acuity and nonadherence to a treatment regimen of anti-vascular endothelial growth factor (VEGF) therapy.
Patients and methods. In this study we included nAMD patients with best corrected visual acuity lower than 0.1 decimal equivalent, nonadherent to anti-VEGF therapy (13 eyes, group I), treatment-naïve (15 eyes, group II) or nonadherence to anti-VEGF therapy followed by termination of anti-VEGF treatment (18 eyes, group III). All participants received comprehensive ophthalmic examination and optical coherence tomography baseline and at the end of the follow-up period.
Results: In group I, 7.6 ± 4.3 intravitreal anti-VEGF injections were performed over a mean period of 38.9 ± 27.5 months. In group II, a mean follow-up was 31.7 ± 28.6 months. In group III 4.8 ± 2.2 intravitreal anti-VEGF injections were performed over a mean period of 26.9 ± 26.4 months followed by treatment discontinuation for a mean period of 24.6 ± 18.6 months. None of study groups showed statistically significant changes in BCVA or an increase of central retinal thickness (p > 0.05). At baseline all study eyes frequently demonstrated severe morphological changes in the macula including atrophy of retinal pigment epithelium (RPE), subretinal fibrosis, RPE tear, or giant intraretinal cysts.
Conclusion: In nAMD patients with low BCVA and severe anatomical changes in the macula nonadherence to a treatment regimen of anti-VEGF therapy results in non-superior long-term outcomes compared to natural course of the disease.
About the Authors
A. N. Kulikov
Military Medical Academy named after S.M. Kirov
Russian Federation
Russian Federation
MD, Professor, head of the Ophthalmology department,
Botkinskaya str., 21, Saint Petersburg, 194044
V. R. Zhalimova
Military Medical Academy named after S.M. Kirov
Russian Federation
Russian Federation
ophthalmologist of the Ophthalmology department,
Botkinskaya str., 21, Saint Petersburg, 194044
D. S. Maltsev
Military Medical Academy named after S.M. Kirov
Russian Federation
Russian Federation
MD, head of Medical retina division of Ophthalmology department,
Botkinskaya str., 21, Saint Petersburg, 194044
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Review
For citations:
Kulikov A.N., Zhalimova V.R., Maltsev D.S. Long-Term Outcomes of Nonadherence to Anti-VEGF Therapy in Advanced Neovascular Age-Related Macular Degeneration. Ophthalmology in Russia. 2022;19(3):658-664. (In Russ.) https://doi.org/10.18008/1816-5095-2022-3-658-664
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