Study finds significant predictors of persistent disease despite treatment with anti-VEGF agents

The presence of retinal fluid and fibrovascular pigment epithelial detachments (PED) after the initial loading phase of anti-VEGF therapy are key predictors of continued disease activity in patients with neovascular age-related macular degeneration (nAMD), according to a study.

The research, derived from the PROOF study, involved a retrospective analysis of data from 600 treatment-naive patients who received their first anti-VEGF injection (ranibizumab, bevacizumab, or aflibercept) between January 2017 and March 2019.

Results showed that 58.10% of patients continued to exhibit retinal fluid at 12 months, and this increased to 66.02% at 24 months. Predictive factors for persistent disease activity included the presence of fibrovascular PED and retinal fluid observed 3 months after the initial loading phase. At 12 months from baseline, visual acuity improved by an average of +6.2 letters with bevacizumab, +10.1 letters with aflibercept, and +13.3 letters with ranibizumab. Central subfield thickness decreased by an average of -79.1 µm with bevacizumab, -96.3 µm with aflibercept, and -134.4 µm with ranibizumab.

Reference
Sagong M, Kim JH, Woo SJ, et al. Predictors of Disease Activity After Anti-VEGF Treatment for Neovascular Age-Related Macular Degeneration Using Real-World Data from the PROOF Study. Ophthalmol Ther. 2024;doi: 10.1007/s40123-024-01021-x. Epub ahead of print. PMID: 39237835.