Age, gender, subtype may influence recurrence of AMD after anti-VEGF treatment

Issue: December 10, 2015

Recurrence of neovascular age-related macular degeneration after anti-VEGF treatment may be associated with age and gender, and occur sooner in patients with polypoidal choroidal vasculopathy, according to a study.

The retrospective cohort study evaluated 343 Asian eyes with subfoveal neovascular age-related macular degeneration (AMD) treated with three monthly loading injections of ranibizumab to investigate the predictive factors of recurrence after more than 1 year.

Overall, 236 eyes showed complete resolution of retinal exudative change after three injections, and 81 eyes experienced no recurrence within 12 months. Of the 236 eyes, retinal exudative change was detected in 155 eyes within 12 months. At 2 years or more of follow-up of 139 eyes, exudation recurred in 104 eyes, or 74.8%.

Baseline characteristics and genotypes were not significantly associated with the response to the loading treatments.

Within 12 months after treatment, older age and male gender were the only predictive factors identified in patients who required re-treatment for recurrence.

At 24 months, age, subtype of AMD and visual acuity (VA) at baseline were associated with VA; improvement was significantly better in eyes without recurrence vs. those with recurrence in that time period.

Among eyes with recurrence, the polypoidal choroidal vasculopathy subgroup had a significantly shorter interval of recurrence at 3.6 ± 2.2 months compared with recurrence at 4.5 ± 2.2 months in eyes with typical AMD.

“Other prognostic factors need to be explored for the purpose of tailoring the ranibizumab treatment regimen to each patient with a favorable improvement of VA and less burden,” the study authors said. – by Kristie L. Kahl

Disclosure: Yamashiro reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.

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Source:

Yamashiro K, et al. Ophthalmology. 2015;doi:http://dx.doi.org/10.1016/j.ophtha.2015.06.053.