A study has found that younger age, lower best-corrected visual acuity (BCVA) score and smaller choroidal neovascularization (CNV) size at baseline were all associated with improvements in visual gains (higher proportion of patients achieving visual acuity (VA) gains ≥15 letters from baseline over a year). Conversely, older age, larger lesion size and predominantly classic CNV were factors associated with greater visual losses (higher proportion of patients losing ≥15 letters from baseline).
Researchers evaluated data from The VEGF Trap-Eye: Investigation of Eﬃcacy and Safety in Wet AMD (VIEW 1 and VIEW 2) studies to identify predictive factors of treatment response in patients with neovascular age-related macular degeneration (nAMD) who have been treated with intravitreal aflibercept (IVT-AFL) or ranibizumab. Younger age (49 to 69 years), lower VA (10.0–≤45.0 Early Treatment Diabetic Retinopathy Study letters) and smaller CNV size (0.0 to ≤3.1 disc areas) at baseline were associated with the most vision gain (≥15 letters) over 52 weeks. Along with treatment, lower VA and smaller central retinal thickness were predictors for dry retina development. A higher proportion of patients achieved a dry retina with IVT-AFL 2q4 and 2q8 than with ranibizumab.
“The ﬁndings from this exploratory, post hoc analysis provide additional insights into possible predictors of visual and anatomical outcomes in patients treated with IVT-AFL or ranibizumab,” the authors noted. They believe as diﬀerent treatment options for nAMD become available, it is of value to patients, physicians and policymakers to determine the likelihood that a patient may respond to a particular drug.
|Lanzetta P, Cruess AF, Cohen SY, et al. Predictors of visual outcomes in patients with neovascular age-related macular degeneration treated with anti-vascular endothelial growth factor therapy: post hoc analysis of the VIEW studies. Acta Ophthalmol. 2018;96(8):e911-8.|