Difference in treatment burden of neovascular age-related macular degeneration among different types of neovascularization

Graefes Arch Clin Exp Ophthalmol. 2021 Jul;259(7):1821-1830. doi: 10.1007/s00417-020-05028-5. Epub 2021 Jan 6.

Abstract

Purpose: To evaluate the difference in the treatment burden among different types of neovascular age-related macular degeneration (AMD).

Methods: This retrospective, observational study included 431 patients who were diagnosed with neovascular AMD. Patients were divided into three groups: type 1 or 2 neovascularization group (n = 167), type 3 neovascularization group (n = 50), and polypoidal choroidal vasculopathy (PCV) group (n = 214). The number of hospital visits per year and the number of anti-vascular endothelial growth factor (VEGF) injections per year were compared among these groups. Furthermore, the incidence of bilateral involvement during the follow-up period was compared among the groups.

Results: The mean follow-up period was 50.6 ± 11.3 months. The number of hospital visits per year was significantly higher in the type 1 or 2 neovascularization group (mean: 6.1 ± 1.5) and type 3 neovascularization (6.6 ± 1.6) than in the PCV group (6.0 ± 1.5) (P < 0.001). The number of anti-VEGF injections per year was significantly higher in type 3 neovascularization group (3.1 ± 1.7) than in the type 1 or 2 neovascularization group (2.3 ± 1.5) or the PCV group (2.3 ± 1.2) (P = 0.042). There was a significant difference in the incidence of bilateral involvement among patients in type 1 or 2 neovascularization group (20.4%), type 3 neovascularization group (46.0%), and the PCV group (15.4%) (P < 0.001).

Conclusions: The high frequency of hospital visits and that of anti-VEGF injections in patients with type 3 neovascularization suggests high treatment burden in these patients. The high incidence of bilateral involvement could be one of the primary reasons for high treatment burden in patients with type 3 neovascularization.

Keywords: Age-related macular degeneration; Burden; Choroidal neovascularization; Polypoidal choroidal vasculopathy; Retinal angiomatous proliferation; Type 3 neovascularization.

Publication types

  • Observational Study

MeSH terms

  • Angiogenesis Inhibitors / therapeutic use
  • Choroid
  • Choroidal Neovascularization* / diagnosis
  • Choroidal Neovascularization* / drug therapy
  • Choroidal Neovascularization* / epidemiology
  • Fluorescein Angiography
  • Humans
  • Intravitreal Injections
  • Retrospective Studies
  • Vascular Endothelial Growth Factor A
  • Visual Acuity
  • Wet Macular Degeneration* / diagnosis
  • Wet Macular Degeneration* / drug therapy
  • Wet Macular Degeneration* / epidemiology

Substances

  • Angiogenesis Inhibitors
  • Vascular Endothelial Growth Factor A