Anti-VEGF therapy did not maintain visual acuity gains in AMD patients at 5 years

SEATTLE — Patients with neovascular age-related macular degeneration who were treated with anti-VEGF therapy did not maintain visual gains at 5 years, according to the Comparison of Age-Related Macular Degeneration Treatment Trials results presented here.

“Our primary goal of the CATT follow-up study was to assess the overall visual acuity and morphologic outcomes at 5 years of any anti-VEGF treatment,” Daniel F. Martin, MD, said at the Association for Research in Vision and Ophthalmology meeting.

Daniel F. Martin

Researchers obtained visual acuity from 647 patients with wet AMD, of which 328 patients were randomized to receive Lucentis (ranibizumab, Genentech), and 319 patients were randomized to receive Avastin (bevacizumab, Genentech). Patients were randomized to receive monthly or as-needed injections of Lucentis or Avastin.

After 2 years, most patients were treated with a drug and dosing strategy that was different from what they were originally assigned, which compromised the researchers’ ability to assess differences between drugs and treatment strategies at 5 years, Martin said.

Mean follow-up time was 5.5 years, and mean number of visits for AMD care was 25.

At the 5-year follow-up, 50% of patients had visual acuity of 20/40 or better, and 20% of patients had visual acuity of 20/200 or worse. Mean change in visual acuity was a loss of three letters from baseline and a loss of 11 letters over 2 years.

“This decrease in vision was accompanied by expansion of the size of the total neovascular complex comprising neovascularization, scarring and atrophy and by persistence of fluid on OCT,” researchers said.

At 5 years, geographic atrophy was present in 41% of gradable eyes. About 83% of patients had fluid as shown on OCT. – by Nhu Te

Reference:

Maguire M. Five-year outcomes with antivascular endothelial growth factor treatment of neovascular age-related macular degeneration. Presented at: ARVO; May 1-5, 2016; Seattle, Washington.

Disclosure: Martin reports no relevant financial disclosures.