Real-world Changes in Injection Frequency and Visual Outcomes Over Time in the Treatment of Neovascular Age-related Macular Degeneration

Abstract

BACKGROUND: To evaluate time-dependent changes in injection frequency and visual outcome for the treatment of neovascular age-related macular degeneration (AMD) and polypoidal choroidal vasculopathy (PCV).METHODS: This retrospective study included 667 patients (667 eyes) diagnosed with treatment-naïve neovascular AMD and PCV in 2013 (2013 group), 2015 (2015 group), 2017 (2017 group), and 2019 (2019 group). The number of anti-vascular endothelial growth factor (VEGF) injections and degrees of changes in visual acuity during the first 24 months after diagnosis were compared among the four time groups.RESULTS: During 24 months, the 2013, 2015, 2017, and 2019 groups received means of 5.7 ± 2.7, 6.0 ± 2.8, 6.6 ± 3.0, and 6.9 ± 3.3 injections anti-VEGF injections, respectively. The number of injections was significantly higher in the 2019 group than in the 2013 and 2015 groups (P = 0.003). The mean degree of visual change during the 24 months follow-up period was 0.07 ± 0.55 deterioration in the 2013 group, 0.01 ± 0.51 deterioration in the 2015 group, 0.08 ± 0.50 improvement in the 2017 group, and 0.04 ± 0.48 improvement in the 2019 group. There was a significant difference in the degree of visual changes among the four groups (P = 0.020).CONCLUSION: There was a trend of increasing injection frequency over time and the visual outcome was relatively better in patients diagnosed in the later period. This trend should be considered when predicting the future socioeconomic burden of neovascular AMD and PCV.