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Anti-VEGFs yield no visual improvement in eyes with fovea-involved macular atrophy

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VANCOUVER, British Columbia — Anti-VEGF treatment did not improve vision in patients with fovea-involved macular atrophy, according to a poster presented at the Association for Research in Vision and Ophthalmology meeting.

“In patients with macular atrophy that involves the fovea at baseline, anti-VEGF does not lead to visual recovery over 3 years,” author Weilin Song, BS, told Healio.com/OSN.

Song, from Case Western Reserve University School of Medicine and Cole Eye Institute, Cleveland, and colleagues undertook the study to investigate the variability in response to anti-VEGF injection in patients with neovascular age-related macular degeneration, she said.

Three cohorts of patients were formed based on their baseline OCT images obtained with the Cirrus HD-OCT (Carl Zeiss Meditec), with macular atrophy measured with Cirrus Review.

Seventy-five eyes were included in the study: 20 had foveal macular atrophy (MA) at baseline, 26 had nonfoveal MA, and 29 had no MA. Researchers evaluated visual acuity 1, 2 and 3 years after anti-VEGF therapy, and, after adjusting for lesion size at baseline, they compared atrophy growth, according to the abstract.

At 3 years, they reported no difference in MA growth when comparing eyes with foveal and nonfoveal MA. The group with foveal MA had an average loss of 18.4 ETDRS letters, those with nonfoveal MA had an average gain of 0.97 letters, and those without MA had an average gain of 9.7 letters.

While acknowledging the small size of the study, Song said the study concludes “that the primary cause of their worse vision was the foveal MA.”

These patients may need dual therapy, she said.

“Don’t stop anti-VEGF” she said. “But in terms of atrophy, a treatment that may be in development for that could be effective in these patients.”

It is important to discuss realistic expectations for visual recovery with these patients, she said. – by Nancy Hemphill, ELS, FAAO

Reference:

Song W, et al. Macular atrophy affecting visual outcomes in patients undergoing anti-VEGF treatment. Presented at: Association for Research in Vision and Ophthalmology; April 28-May 2, 2019; Vancouver.

Disclosure: Song reports no relevant financial disclosures. Please see study abstract for all other authors’ disclosures.