PDF
ePub
Citation
Print
Abstract
Purpose
To investigate the timing and incidence of long-term recurrence in patients with typical neovascular age-related macular degeneration (AMD) or polypoidal choroidal vasculopathy (PCV), in patients with no recurrence during the first year after diagnosis.
Methods
A retrospective review of medical records was performed for typical neovascular AMD or PCV patients with no recurrence during 10 months after three, monthly anti-vascular endothelial growth factor injections. The timing and incidence of recurrence after 10 months were identified. In addition, parameters were compared between the recurrence group and the no recurrence group to identify predictive factors for long-term recurrence.
Results
The results were analyzed using 49 eyes from 49 patients, with 19 eyes with typical neovascular AMD and 30 eyes with PCV. Patients were followed-up for a mean period of 32.3 ± 9.3 months after three loading injections. Recurrence was noted in 20 eyes (40.8%) at a mean of 22.6 ± 9.4 months after the third anti-vascular endothelial growth factor injection. The timing of recurrence was as follows: 13 eyes at ≥ 12 months and < 24 months, four eyes at ≥ 24 months and < 36 months, and three eyes at ≥ 36 months. When comparing the recurrence and no-recurrence groups, the follow-up period was significantly longer in the recurrence group (p = 0.003). However, there was no other factors that were significantly associated with recurrence.
Figures and Tables
 | Figure 1Kaplan-Meier curves showing cumulative incidence of recurrence, according to the follow-up period. There was no significant difference in the recurrence between typical neovascular age-related macular degeneration (AMD) and polypoidal choroidal vasculopathy (p=0.842).
|
Table 1
Characteristics of patients who did not experience recurrence during the 10 months after the third anti-vascular endothelial growth factor injection (n = 49)
Table 2
Comparison of characteristics between patients with and without recurrence (n = 49)
Data are presented as mean ± standard deviation when applicable.
AMD = age-related macular degeneration; BCVA = best-corrected visual acuity; logMAR = logarithm of minimal angle of resolution; VEGF = vascular endothelial growth factor.
*Statistical analysis performed using the Mann-Whitney U test; †Statistical analysis performed using the Fisher's exact test; ‡Statistical analysis performed using the Chi-square test; §Statistical analysis performed using the independent samples t-test.
Table 3
Comparison of characteristics between early recurrence group and late recurrence group (n = 20)
Data are presented as mean ± standard deviation when applicable.
AMD = age-related macular degeneration; BCVA = best-corrected visual acuity; logMAR = logarithm of minimal angle of resolution; VEGF = vascular endothelial growth factor.
*Statistical analysis performed using the Mann-Whitney U test; †Statistical analysis performed using the Fisher's exact test.
References
1. Bressler SB, Bressler NM, Fine SL, et al. Natural course of choroidal neovascular membranes within the foveal avascular zone in senile macular degeneration. Am J Ophthalmol. 1982; 93:157–163.
2. Maguire MG, Martin DF, Ying GS, et al. Five-year outcomes with anti-vascular endothelial growth factor treatment of neovascular age-related macular degeneration: the comparison of age- related macular degeneration treatments trials. Ophthalmology. 2016; 123:1751–1761.
3. Yannuzzi LA, Sorenson J, Spaide RF, Lipson B. Idiopathic polypoidal choroidal vasculopathy (IPCV). 1990. Retina. 2012; 32:Suppl 1. 1–8.
4. Laude A, Cackett PD, Vithana EN, et al. Polypoidal choroidal vasculopathy and neovascular age-related macular degeneration: same or different disease? Prog Retin Eye Res. 2010; 29:19–29.
5. Oishi A, Kojima H, Mandai M, et al. Comparison of the effect of ranibizumab and verteporfin for polypoidal choroidal vasculopathy: 12-month LAPTOP study results. Am J Ophthalmol. 2013; 156:644–651.
6. Lee MH, An JH, Lee JE, Oum BS. Short-term efficacy of intravitreal bavacizumab for polypoidal choroidal vasculopathy. J Korean Ophthalmol Soc. 2009; 50:51–60.
7. Rosenfeld PJ, Brown DM, Heier JS, et al. Ranibizumab for neovascular age-related macular degeneration. N Engl J Med. 2006; 355:1419–1431.
8. Heier JS, Brown DM, Chong V, et al. Intravitreal aflibercept (VEGF trap-eye) in wet age-related macular degeneration. Ophthalmology. 2012; 119:2537–2548.
9. Fung AE, Lalwani GA, Rosenfeld PJ, et al. An optical coherence tomography-guided, variable dosing regimen with intravitreal ranibizumab (Lucentis) for neovascular age-related macular degeneration. Am J Ophthalmol. 2007; 143:566–583.
10. Kuroda Y, Yamashiro K, Miyake M, et al. Factors associated with recurrence of age-related macular degeneration after anti-vascular endothelial growth factor treatment: a retrospective cohort study. Ophthalmology. 2015; 122:2303–2310.
11. Kim JH, Chang YS, Lee DW, et al. Incidence and timing of the first recurrence in neovascular age-related macular degeneration: comparison between ranibizumab and aflibercept. J Ocul Pharmacol Ther. 2017; 33:445–451.
12. Inoue M, Yamane S, Sato S, et al. Comparison of time to retreatment and visual function between ranibizumab and aflibercept in age-related macular degeneration. Am J Ophthalmol. 2016; 169:95–103.
13. Lim JH, Wickremasinghe SS, Xie J, et al. Delay to treatment and visual outcomes in patients treated with anti-vascular endothelial growth factor for age-related macular degeneration. Am J Ophthalmol. 2012; 153:678–686.
XML Download