The LATAR study has been tracking more than 1,000 patients treated with anti-VEGF injections for at least 10 years now, beginning in 2006. The most recent data is finally out, and the results should give clinicians and patients some peace of mind that the therapy is worth the hassle. The researchers examined demographic data, visual acuity and the number of intravitreal injections the patients received. At baseline, the researchers graded fundus fluorescein angiograms and OCT images for choroidal neovascularization type, central macular thickness and presence of fluid over 10 years.
The main outcome measure of the study was vision change at 10 years, with secondary outcomes such as the proportion of eyes with 20/40 vision or better and 20/200 or worse, and the proportion of eyes that was dry on OCT imaging.
Of the 1,046 eligible eyes initially enrolled, 293 eyes (28%) had complete 10-year data and were included in the analysis. The 293 eyes received a mean of 58.1±23.6 injections over the 10-year period, and the researchers noted that the mean central macular thickness decreased from 355.5μm to 264.2μm.
In terms of visual acuity, the median baseline visual acuity was 60 letters, and this improved significantly by nine letters after the first year of treatment. However, these initial gains were lost over the 10-year period, and the final visual acuity change was just three letters. The researchers noted, however, that the proportion of eyes with visual acuity 20/40 or better increased significantly from 29% at baseline to 35% at 10 years. The proportion of patients with visual acuity of 20/200 or worse at baseline increased as well, from 14% to 17% over 10 years.
The researchers concluded that, on average, eyes with neovascular AMD maintained their starting visual acuity over the 10-year treatment period with anti-VEGFs. “With ongoing regular treatment,” they added, “a greater proportion of eyes achieved visual acuity of 20/40 or better at 10 years than at presentation.”
Spooner K, Fraser-Bell S, Hong T, et al. Long-term anti-VEGF treatment for neovascular age-related macular degeneration. The LATAR Study Report 1: Ten-year, real-world outcomes. Ophthalmology Retina. September 29, 2020. [Epub ahead of print].