New research published in the British Journal of Ophthalmology reports only one-in-five wet AMD patients will retain good vision—BCVA of 70 or more ETDRS letters—in their first-affected eye at 10 years after starting anti-VEGF treatment. The study also found one-in-two patients had good vision in their better-seeing eye after a decade of treatment.

The investigation analyzed 10-year trends of VA and anatomical outcomes and treatment burden of 103 treatment-naïve individuals with wet AMD who received anti-VEGF therapy.

The researchers considered first-affected eyes with wet AMD that were treated with ranibizumab before 2009. The study’s primary outcome was time to BCVA falling by 35 or fewer letters after initiating anti-VEGF therapy. The secondary outcomes included the following: time to BCVA that reached 70 or more letters; proportion of eyes with BCVA of 70 or more and 35 or fewer letters after 10 years; mean trend of BCVA; central retinal thickness over a decade; and mean number of injections.

Following the onset of anti-VEGF therapy, the median time for BCVA to reach 35 or less and 70 or more letters was about 38 months and eight months, respectively. At the final follow-up, BCVA in first-affected eye was 35 or less letters in about 41% of participants and 70 or more letters in about 21% of patients, compared with roughly 5% and 48%, respectively, in the patients’ better-seeing eye.

Subjects received 37.0 injections per eye and 53.6±30.1 at patient level, while approximately 63% required injections in both eyes.

The chronicity of nAMD disease and its management highlight the importance of long-term visual prognosis, and early treatment may lead to better visual outcomes, researchers noted.  

Arpa C, Khalid H, Chandra S, et al. Ten-year survival trends of neovascular age-related macular degeneration at first presentation. Br J Ophthalmol. October 3, 2020. [Epub ahead of print].