TEN-YEAR FOLLOW-UP OF PATIENTS WITH EXUDATIVE AGE-RELATED MACULAR DEGENERATION TREATED WITH INTRAVITREAL ANTI-VASCULAR ENDOTHELIAL GROWTH FACTOR INJECTIONS

Purpose: To identify the visual acuity outcomes of patients with age-related macular degeneration treated with intravitreal anti-vascular endothelial growth factor injections over a 10-year period. Methods: This was a retrospective, cohort study of eyes with exudative age-related macular degeneration that received >= 2 intravitreal anti-vascular endothelial growth factor injections and had at least 10 years of follow-up after the initiation of treatment. Snellen visual acuity was recorded at baseline and then annually until the last year of follow-up. Optical coherence tomography data were collected at the time of treatment initiation and at the last examination visit. A subanalysis was performed on patients who continued to receive anti-vascular endothelial growth factor therapy using a modified treat and extend protocol versus those who discontinued treatment for longer than 1 year. Results: One hundred thirty eyes of 115 patients met the inclusion criteria. The mean follow-up after treatment initiation was 11.1 +/- 0.7 years. Eyes received an average of 45.1 +/- 32.3 intravitreal injections in total and a mean of 5 to 7 injections per year. The baseline mean logMAR visual acuity was 0.61 +/- 0.5 (Snellen acuity 20/81), and the final mean logMAR visual acuity was 0.88 +/- 0.7 (20/152,Pvalue = <0.0001). There were 40 eyes that received at least one injection every year. These eyes did not have a significant change in visual acuity between the baseline and final examinations 0.47 +/- 0.4 (20/59 vs. 0.58 +/- 0.5 [20/76,P= 0.28]), whereas the eyes that did not receive at least one injection every year saw a significant decline in visual acuity 0.67 +/- 0.5 (20/94 vs. 1.01 +/- 0.7 [20/205,P< 0.0001]). Conclusion: Eyes with exudative age-related macular degeneration that received intravitreal injections every year had stable visual acuity over a 10-year period. Continuous intravitreal anti-vascular endothelial growth factor therapy may stabilize visual acuity for 10 years and potentially longer.