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Geographic atrophy outside CNV lesion at baseline may indicate later development
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Predominantly hemorrhagic lesions may develop both within and more than 3.5 years after initiation of anti-VEGF therapy for choroidal neovascularization in eyes with age-related macular degeneration.
However, new geographic atrophy is unlikely to develop beyond lesion boundaries unless geographic atrophy occurred beyond the lesion’s boundaries initially, according to study findings.
Researchers retrospectively reviewed the records for 81 eyes of 75 patients with choroidal neovascularization secondary to AMD who underwent anti-VEGF injections and had at least 3.5 years of follow-up data. Mean follow-up was 4.9 years, and 40% of the patients had at least 6 years of follow-up data.
Patients received a median of seven injections in the first 2 years, five injections between the 2-year visit and 3.5 years, and two injections from 3.5 to 6 years after the start of treatment.
The primary outcome measure was the presence of predominantly hemorrhagic lesions or geographic atrophy (GA).
Median visual acuity was 20/80 at baseline, 20/63 at 2 years, 20/80 at 3.5 years and 20/63 at 6 years.
Predominantly hemorrhagic lesions were identified in six eyes. Hemorrhagic lesions developed in an additional three eyes at 3.5 years and in one additional eye after 3.5 years.
GA within or overlapping the boundary of the entire CNV was identified in four eyes and outside the boundary in eight eyes.
GA outside the CNV boundary only developed in eyes that had GA outside the lesion at baseline.
Additional atrophy within the boundary of CNV defined at baseline, or atrophic disciform scars, developed in five eyes within 4 years of the start of treatment, the authors said.
Disclosure: See the study for a full list of all authors’ relevant financial disclosures.
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