Neovascular Age-Related Macular Degeneration in the Very Old (≥90 Years): Epidemiology, Adherence to Treatment, and Comparison of Efficacy.

Abstract:

PURPOSE:To investigate neovascular age-related macular degeneration (AMD) in patients aged ≥90 years from several perspectives for a comprehensive overview: prevalence, presenting characteristics, treatment adherence, reasons for discontinuation, and efficacy of antivascular endothelial growth factor (VEGF) treatment comparing Ranibizumab and Aflibercept. METHODS:In this retrospective chart review, we determined the prevalence and presenting characteristics by reviewing all data for patients referred to our department with treatment-naïve neovascular AMD. By looking at historical cohorts, we determined adherence to treatment, reasons for discontinuation, and treatment outcomes after loading dose, 12 months, and 24 months. RESULTS:Patients aged ≥90 years constituted 7% of the patients. Treatment was discontinued in 51%, primarily because of death and treatment burden. Mean change in best-corrected visual acuity was 3.2, 1.5, and -2.2 ETDRS letters at 4, 12, and 24 months, respectively. Aflibercept was superior to Ranibizumab in visual and anatomic outcomes. After two years of treatment, patients losing ≥15 ETDRS letters made up 19% in the Aflibercept group and 26% in the Ranibizumab group. CONCLUSIONS:We propose that the very old patients with neovascular AMD may constitute a distinctive group warranting special attention and possibilities for individualized therapy. Possible differences between anti-VEGF agents need further investigations.

journal_name

J Ophthalmol

journal_title

Journal of ophthalmology

authors

Subhi Y,Sørensen TL

doi

10.1155/2017/7194927

subject

Has Abstract

pub_date

2017-01-01 00:00:00

pages

7194927

eissn

2090-004X

issn

2090-0058

journal_volume

2017

pub_type

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