Insufficient treatment common among patients with wet AMD
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NEW YORK — A large number of eyes with newly diagnosed wet age-related macular degeneration received insufficient treatment, leading to poor outcomes and vision loss, according to a study.
In a presentation at the American Society of Retina Specialists annual meeting, Anita Barikian, MD, said despite the demonstrated benefit of anti-VEGF therapy in wet AMD, challenges in managing the disease can affect patient outcomes.
To better understand the relationship between treatment patterns and outcomes, Barikian and colleagues explored data from the IRIS Registry, including treatment-naive eyes with newly diagnosed wet AMD between 2013 and 2019 with a best corrected visual acuity of at least 20/400. Patients had anti-VEGF treatment within 3 months of diagnosis and 1 year of follow-up. Eyes were categorized as “insufficiently treated” if they received fewer than seven anti-VEGF injection in 1 year.
Of the 184,258 eyes included in the study, 74,562 (40.5%) had insufficient treatment and 109,696 (59.5%) had sufficient treatment. The mean number of injections was four in the insufficient group and 8.9 in the sufficient group.
Barikian said Asian, Black and Hispanic patients, as well as patients who had Medicaid insurance and those who saw non-retina specialists, were all less likely to receive sufficient treatment (all P < .001).
Eyes that had sufficient treatment had better mean change in BCVA from baseline compared with eyes with insufficient treatment (3.4 letters vs. –0.1 letters).
“The observed visual acuity benefits were larger in patients with worse baseline BCVA,” Barikian said. “These findings may help physicians identify gaps in care leading to suboptimal outcomes during management of neovascular AMD.”
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Barikian A, et al. Characteristics and outcomes of patients with nAMD managed in US routine clinical practice: An analysis of the IRIS Registry database. Presented at: American Society of Retina Specialists annual meeting; July 13-16, 2022; New York.
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