J Korean Ophthalmol Soc > Volume 59(11); 2018 > Article
Journal of the Korean Ophthalmological Society 2018;59(11):1030-1038.
DOI: https://doi.org/10.3341/jkos.2018.59.11.1030    Published online November 15, 2018.
Significance of Early Visual Responses to Anti-Vascular Endothelial Growth Factor in Age-related Macular Degeneration.
Hee Jun Song, Ji Ho Yang, Do Gyun Kim
Department of Ophthalmology, Myongji Hospital, Goyang, Korea. Kimdk89@empas.com
신생혈관 연령관련황반변성에서 항혈관내피세포성장인자 주입술 시행 후 시력 반응의 의의
송희준⋅양지호⋅김도균
명지병원 안과
Correspondence:  Do Gyun Kim,
Email: Kimdk89@empas.com
Received: 12 July 2018   • Revised: 10 August 2018   • Accepted: 22 October 2018
Abstract
PURPOSE
To evaluate whether early visual acuity response at 4 weeks after the first intravitreal anti-vascular endothelial growth factor (VEGF) injection or 4 weeks after the third injection in neovascular age-related macular degeneration (nAMD) is associated with 12-month follow-up outcome. METHODS: Thirty treatment-naive patients (30 eyes) with nAMD, treated with intravitreal anti-VEGF, were retrospectively included. Initially, all patients were injected at least three times for three consecutive months and followed up with a pro re nata regimen for at least 12 months. The relationship between 4 weeks after the first and third anti-VEGF injections in visual acuity response was explored, including the mean change from baseline in best-corrected visual acuity (BCVA). The mean change in BCVA was classified into three groups according to visual improvement: <1, 1-<3, or ≥ 3 logMAR line(s) in BCVA. The associations among baseline characteristics (gender, age, duration of symptoms, initial BCVA, central macular thickness, and intraocular pressure) and visual acuity responses 4 weeks after the first and third anti-VEGF injections were also assessed. RESULTS: The proportions of eyes with <1, 1-<3, and ≥ 3-line(s) improvement at 4 weeks after the first injection were 6 eyes (20%), 7 eyes (23.3%), and 17 eyes (56.6%), respectively. The proportions of eyes with <1, 1-<3, and ≥ 3-line(s) improvement at 4 weeks after the third injection were 9 eyes (30%), 9 eyes (30%), and 12 eyes (40%), respectively. A BCVA response ≥ 3-lines improvement at 4 weeks after the third injection showed significant associations with ≥ 3-lines improvement and BCVA response at 12 months in multiple logistic and linear regression analyses (p = 0.04). CONCLUSIONS: In this study, BCVA response ≥ 3-lines improvement at 4 weeks after the third injection showed a significant association with ≥ 3-lines improvement and BCVA response at 12 months.
Key Words: Anti-vascular endothelial growth factor;Early response;Neovascular age-related macular degeneration;Visual response


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