2 Year Follow up of Real World Patients with Age-related Macular Degeneration treated with Ranibizumab

Abstract

Purpose To evaluate the efficacy of Lucentis (ranibizumab) in the treatment of age-related macular degeneration in a real-world retrospective study. Methods This is a retrospective real world observational study of patients with age-related macular degeneration treated between 2013 - 2019 who received Ranibizumab free of charge in a 2-year program from the Hospital Authority. The primary outcome was visual acuity at 12 and 24 months. Secondary outcomes were the average number of injections at 12 and 24 months, and final change in VA letters at 24 months. Results There were 193 eyes recruited from 189 patients. The average age was 83.6 years old, there were 130 (67.4%) males and 92 (47.7%) left eyes treated. The VA was 48.7 letters at baseline, 53.8 letters (+5.1,p=0.2256) at 6 months, 54.6 letters (+5.9, p=0.1886) at 1 year and 39.2 letters (-9.5, p=0.0003) at 24 months. At the final visit, 39.9% of eyes lost 15 or more letters; 9.8% lost 1 - 14 letters; while 11.9% gained 1 - 14 letters and 13.5% gained 15 or more letters. There was no change in 24.9% of eyes. The average number of all injections at 24 months was 7.28 per patient; with 4.66 injections in the first 12 months and 2.617 from month 12 to 24. Conclusion This study shows visual acuity gained from anti-VEGF treatment of nAMD is eventually lost after 24 months in a real world situation if a Pro-Re-Nata protocol is used, even when patients don’t bear any cost. The average number of injections in treatment-naive patients were 4.58 and 2.55 while previously treated patients received 4.74 and 2.69 injections at 12 and 24 months respectively.