Patients requiring just one anti-VEGF treatment have similar baseline qualities

WAILEA, Hawaii — The subset of age-related macular degeneration patients who show resolution of fluid with just one injection of anti-VEGF therapy share similar baseline characteristics, a surgeon said here.

Jay S. Duker

"This study really started to help us define the subset of patients for the minimum treatments. Better initial vision, classic lesions smaller than one disc area, obviously less macular fluid, non-subfoveal membranes tend to need minimum treatment," Jay S. Duker, MD, said at Retina 2009.

Dr. Duker presented a retrospective study of 62 patients who were followed over 1 year after receiving one initial injection of Lucentis (ranibizumab, Genentech). Patients were re-treated as deemed necessary by the surgeon.

Of these patients, 31% needed only one injection to achieve full resolution of fluid. These 16 patients had an initial visual acuity of 20/66 and an optical coherence tomography measurement of 263 µm as compared with the two-injection group at 20/76 and 279 µm, the three-injection group at 20/80 and 297 µm and the four-injection group at 20/93 and 410 µm.

"You might say, 'Of course, the patients who were worse needed more injections,' but that is obvious at the end. It's not obvious at the beginning. When you see the patient in front of you, you don't know how many injections they are going to get," Dr. Duker said.