Outcomes of Intentionally Suspending Treatment in Eyes With Advanced Neovascular Age-Related Macular Degeneration

PURPOSE: To determine the outcomes of intentionally suspending anti-vascular endothelial growth factor (anti-VEGF) injections in eyes with advanced neovascular age related macular degeneration (nAMD). DESIGN: Retrospective cohort study. METHODS: The study sample comprised 93 patients with nAMD and best available Snellen visual acuity (VA) <= 20/400 in which anti-VEGF treatment was suspended by the treating physician. VA and optical coherence to-mography (OCT) characteristics were evaluated to de-termine visual and anatomical outcomes up to 24 months after treatment suspension. RESULTS: A total of 93 eyes from 93 patients who had received a mean of 16 anti-VEGF injections over mean of 962 (SD 562) days were included. Comparing the treatment suspension visit to 24 months later, no sig-nificant change in mean central foveal thickness (163 [SD 118, range 19-704] mu m vs 164 [SD 217, range 19-1468], P = .97), greatest lesion diameter (2547 [SD 1294, range 134-5707] mu m vs 2442 [SD 1158, range 421-5305] mu m, P = .43), greatest lesion thickness (194 [SD 136, range 0-618] mu m vs 205 [SD 131, range 0-573] mu m, P = .40), or VA (1.87 [SD 0.37], 20/1482, vs 1.94 [SD 0.28], 20/1741, P = .16) was found. In total, 7 eyes (7.5%) restarted treatment following a mean of 977 (SD 450) days after treatment suspension. CONCLUSIONS: Suspension of anti-VEGF injections in eyes with advanced nAMD and VA <= 20/400 may be rea-sonable in cases where the treating physician deems addi-tional treatment is unlikely to provide benefit. Although the visual and anatomical findings remained stable after treatment suspension in most, a small number restarted