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Influence of lesion location on lesion reactivation after initial treatment in neovascular age-related macular degeneration

  • Retinal Disorders
  • Published:
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Abstract

Purpose

We aim to evaluate the factors associated with the incidence of lesion reactivation after initial loading injections in patients with neovascular age-related macular degeneration (AMD).

Methods

This retrospective study included patients diagnosed with treatment-naïve neovascular AMD who received three loading injections of either ranibizumab or aflibercept. After the initial treatment, patients were followed up every 1–2 months during the first year and the follow-up interval was extended to 4 months during the second year. Retreatment was administered on an as-needed basis. The incidence and timing of lesion reactivation at 24 months after diagnosis were identified. In addition, Cox’s proportional hazard model was used to evaluate the association of baseline factors with lesion reactivation. Lesion reactivation was defined re-accumulation of subretinal fluid/intraretinal fluid or the development of subretinal/intraretinal hemorrhage.

Results

A total of 284 patients (173 men and 111 women) were included in the study. The mean age of the patients was 70.5 ± 8.8 years. During the 24-month follow-up period, lesion reactivation was observed in 216 eyes (76.1%) at a mean of 8.2 ± 4.4 months after diagnosis. The incidence of lesion reactivation was 62.5% in extrafoveal macular neovascularization (MNV), 75.0% in juxtafoveal MNV, and 79.5% in subfoveal MNV. The extrafoveal MNV showed significantly lower incidence of lesion reactivation than subfoveal MNV (P = 0.041, hazard ratio = 0.64).

Conclusions

Extrafoveal MNVs showed a lower incidence of lesion reactivation after initial treatment than subfoveal MNVs. This result should be considered when interpreting the results of clinical trials with different eligibility criteria regarding lesion location.

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Funding

Kim’s Eye Hospital (Seoul, South Korea) provided funding for English editing support. The sponsor had no role in the design or conduct of the study.

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Correspondence to Jae Hui Kim.

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This study was approved by the Institutional Review Board of Kim’s Eye Hospital (Seoul, South Korea) and conducted in accordance with the tenets of the Declaration of Helsinki.

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Informed consent was not obtained as no participant information was identified in this study.

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Kim, J.H., Kim, J.W. & Kim, C.G. Influence of lesion location on lesion reactivation after initial treatment in neovascular age-related macular degeneration. Graefes Arch Clin Exp Ophthalmol 261, 3139–3148 (2023). https://doi.org/10.1007/s00417-023-06144-8

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