Eyes with wet AMD may achieve satisfactory long-term visual outcomes if they receive adequate treatment, a newly published study shows. The research adds that central macular atrophy does not develop universally in eyes on long-term treatment with anti-VEGF, as previously feared.

The investigators looked at 712 treatment-naive eyes starting anti-VEGF (321 from Switzerland and 474 from Australia or New Zealand) for AMD in routine clinical practice between 2006 and 2008. The mean visual acuity (VA) in 132 eyes (28%) from Australia or New Zealand that completed 10 years of treatment dropped by 0.9 letters from the baseline while 37 eyes (12%) from Switzerland lost 14.9 letters with 35% achieving ≥20/40.

The Australia and New Zealand eyes received more injections than eyes from Switzerland (a median of 53 vs. 42). This research supports a treat-and-extend regimen model, the investigators wrote in their paper. Macular atrophy and subretinal fibrosis were the main reasons for 10-letter loss in the subset of eyes analyzed retrospectively.

The mean VA of eyes from both regions that discontinued treatment within 10 years had fallen below the baseline at their final visit.

Gilliesa M, Arnold J, Bhandaria S, et al. Ten-Year Treatment Outcomes of Neovascular Age-Related Macular Degeneration from two regions. Am J Ophthalmol. October 10, 2019. [Epub ahead of print].