Real-World Outcomes in Pre-Existing Neovascular Age-Related Macular Degeneration Subjects Undergoing Avacincaptad Therapy for Geographic Atrophy.

Clinical ophthalmology (Auckland, N.Z.) Pub Date : 2024-12-27 eCollection Date: 2024-01-01 DOI:10.2147/OPTH.S497678
Ryan B Rush, Westin Klein, Sloan W Rush, Robert M Reinauer
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Abstract

Purpose: To evaluate real-world outcomes in subjects with pre-existing neovascular age-related macular degeneration (AMD) undergoing intravitreal avacincaptad pegol (IVA) treatment for geographic atrophy (GA).

Methods: This study was undertaken as a retrospective, case-controlled assessment of patients undergoing IVA treatment for GA from 2 community-based retina practices. Patients were separated into 1) a Study Group consisting of subjects with pre-existing neovascular AMD prior to initiation of IVA for GA, and 2) a Control Group consisting of AMD subjects without neovascularization prior to initiation of IVA for GA. Study and Control Group subjects had a baseline visual acuity of ≥ 20/200, a total GA lesion area of ≥ 1 mm2 and ≤ 17.5 mm2, and follow-up of 12-months following IVA commencement.

Results: A total of 64 patients were analyzed. No significant differences in baseline characteristics were found between cohorts. The Study Group had a greater decrease in visual acuity [-0.2 (-0.24 to -0.16) logMAR versus -0.04 (-0.06 to 0.02) logMAR; p<0.0001], a greater increase in GA lesion growth [1.36 (1.09-1.63) mm2 versus 0.52 (0.34-0.70) mm2; p<0.0001], and a higher incidence of exudation (p=0.0002) compared to the Control Group during the study period.

Conclusion: This study suggests that patients undergoing IVA therapy for GA with pre-existing neovascular AMD have worse visual and anatomic outcomes at 12-months compared to a matched control group without pre-existing neovascularization; such patients therefore should be carefully counseled prior to initiation of IVA for the management of GA.

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已存在的新生血管性年龄相关性黄斑变性患者接受空白性脑萎缩治疗的真实世界结果
目的:评估已存在的新生血管性年龄相关性黄斑变性(AMD)患者在接受玻璃体内avacincaptad pegol (IVA)治疗地理萎缩(GA)时的实际结果。方法:本研究对来自2个社区视网膜诊所接受静脉注射治疗的GA患者进行回顾性、病例对照评估。患者被分为两组:1)研究组,包括在GA的IVA治疗开始前已经有新生血管性AMD的患者;2)对照组,包括在GA的IVA治疗开始前没有新生血管性AMD的患者。研究和对照组受试者基线视力≥20/200,GA总病变面积≥1mm2≤17.5 mm2, IVA开始后随访12个月。结果:共分析64例患者。在队列之间没有发现基线特征的显著差异。研究组的视力下降幅度更大[-0.2(-0.24至-0.16)logMAR相比-0.04(-0.06至0.02)logMAR;P2 vs 0.52 (0.34-0.70) mm2;结论:本研究表明,与没有新生血管形成的对照组相比,接受IVA治疗的GA合并新生血管性AMD患者在12个月时的视觉和解剖结果更差;因此,在开始IVA治疗GA之前,应仔细咨询此类患者。
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