Purpose: To investigate the long-term effectiveness of as-needed anti-vascular endothelial growth factor therapy on age-related macular degeneration (AMD).
Subjects and methods: The number of treatments, treatment period, visual acuity and morphological changes were investigated retrospectively in 257 eyes of 248 patients (189 men and 59 women, mean age±SD; 71.1±9.2 years old) who were followed up for two years and more. Re-treatment was mainly decided based on patient's will.
Results: The mean number of treatments was 6.4±3.8 in the observational period of 3.7 years. Exudative changes were resolved at least once in the observational period in 240 eyes, and 160 eyes had no exudative changes at the final visit. Type 2 neovascularization by Gass resulted in fibrotic scar more frequently than type 1. The mean decimal visual acuity was 0.36 before the initiation of treatment and 0.26 at the final visit. The treatment period was less than 100 days in 54 eyes, and multivariate analysis revealed that polypoidal choroidal vasculopathy (PCV) was a factor of prolonged treatment period. No severe adverse effects were admitted locally and systemically.
Conclusions: The deterioration of mean visual acuity was assumed to be due to the relatively small number of treatments. Twenty-one percent of all eyes preserved well without any recurrence of treatments for short periods, and PCV needed treatments for longer periods than typical AMD.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 120: 91-100, 2016.