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Rate of vision loss in neovascular age-related macular degeneration explored

  • Retinal Disorders
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To explore decline in visual acuity in patients with neovascular age-related macular degeneration (n-AMD) awaiting intravitreal bevacizumab or ranibizumab treatment following initial diagnosis and after disease reactivation.

Methods

Retrospective analysis of 74 treatment-naïve patients (84 eyes) in two centers in Córdoba, Argentina. The time between treatment indication and intravitreal injection, and the changes in BCVA produced during this delay were studied in both periods. A linear regression model to search the impact of time on progression visual impairment was conducted.

Results

In both periods, a significant reduction in vision occurred awaiting intravitreal injection. The longer the delay, the greater the vision loss (R2 = 0.55 p < 0.01) and the less improvement following treatment (Pearson coefficient −0.26). The result of the model shows that the change in vision as a function of initial delay were best described by a polynomic model with a mean loss of 5 letters in the first 3 weeks, a slowdown in the rate of change of VA, and a dependence of visual acuity at the moment of diagnosis . The loss of visual acuity after reactivation shows the same behavior as at the onset of the disease but independent of visual acuity prior to reactivation.

Conclusion

Visual loss awaiting injection intravitreal anti-VEGF is clinically significant and with an asymptotic pattern, with early rapid loss of vision in both the onset of the disease and the reactivation. Initiation of anti-VEGF treatment must be undertaken urgently, as should retreatment of disease activation to reduce visual loss.

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Acknowledgments

The authors are grateful to Centro Privado de Ojos Romagosa SA-Fundación VER and University Clinic Reina Fabiola for their assistance. All authors participated in the development and writing of this manuscript and are fully responsible for this study.

Declarations

SPK declares attending advisory boards of Bayer and Novartis and conference travel from Alcon, Bayer, and Novartis and lecture fees from Novartis. The authors declare no conflict of interest.

Funding statement

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Pharmacy Department of the Faculty of Chemical Sciences, National University of Córdoba UNITEFA (CONICET), Cordoba, Argentina

    Juan P. Real, Gladys E. Granero & Santiago D. Palma

  2. Vitreo-Retinal Department, Centro Privado de Ojos Romagosa SA - Fundación VER, Córdoba, Argentina Dean Funes, 432, 5000, Córdoba, Argentina

    Claudio P. Juarez & José D. Luna

  3. Institute of Economics and Finance, School of Economics Sciences, National University of Córdoba, Córdoba, Argentina

    Mariana O. De Santis

  4. Ophthalmology Department, Royal Bolton Hospital, Bolton, UK

    Simon P. Kelly

Authors
  1. Juan P. Real
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  2. Gladys E. Granero
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  3. Mariana O. De Santis
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  4. Claudio P. Juarez
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  5. Santiago D. Palma
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  6. Simon P. Kelly
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  7. José D. Luna
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Corresponding author

Correspondence to José D. Luna.

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Real, J.P., Granero, G.E., De Santis, M.O. et al. Rate of vision loss in neovascular age-related macular degeneration explored. Graefes Arch Clin Exp Ophthalmol 253, 1859–1865 (2015). https://doi.org/10.1007/s00417-014-2885-y

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  • DOI: https://doi.org/10.1007/s00417-014-2885-y

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