Suspending injections may be reasonable in nonresponders with wet AMD, low vision
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MONTEREY, Calif. — Suspension of treatment may be reasonable in selected patients with advanced wet age-related macular degeneration and low vision who are poor responders to anti-VEGF injections, according to a study.
“Due to the exclusion of these eyes from the pivotal clinical trials, it is unclear whether continuing treatment is necessary or effective,” and “there is little data on the safety of this practice,” Katherine Awh, BA, wrote in a poster presented at the Women in Ophthalmology 2022 Summer Symposium.
The study consisted of a retrospective chart review of 93 eyes with wet AMD and visual acuity less than 20/400 in which anti-VEGF treatment was suspended. A mean of 16 injections were performed over a mean of 962 days. At treatment initiation, mean visual acuity was 20/364 and had further worsened to 20/1428 when the decision was made to suspend the treatment.
In two eyes, treatment was restarted within the 24 months following suspension, and in five additional eyes, it was restarted by the final visit. Reasons for restarting injections included reactivation of choroidal neovascularization in four eyes and hemorrhage in three eyes. In the vast majority of eyes, visual and anatomical outcomes remained stable 24 months after treatment suspension.
“Suspension of anti-VEGF injections in eyes with advanced nAMD and VA 20/400 may be reasonable in select cases where the physician deems additional treatment is futile,” Awh said.
However, the small number of eyes in which anti-VEGF therapy was restarted suggests that regular monitoring is still needed, she said.
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Awh K. Outcomes of suspending treatment in eyes with advanced neovascular age-related macular degeneration. Presented at: Women in Ophthalmology Summer Symposium; Aug. 25-28, 2022; Monterey, California (hybrid meeting).
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