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J Fr Ophtalmol ; 43(10): 989-995, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-33081995

RESUMEN

PURPOSE: To report predictive factors for therapeutic response to anti-VEGF in patients with neovascular age-related macular degeneration (nAMD) in daily clinical practice in our patient population. METHODS: Retrospective cohort study including 56 patients (69 eyes) with nAMD treated with anti-VEGF, followed for at least two years between February 2012 and April 2018. Patients received three intravitreal anti-VEGF (bevacizumab) injections (loading dose) and were monitored and treated according to a PRN regimen. We analysed whether a gain in visual acuity of 15 or more ETDRS letters at the final visit was associated with demographic characteristics, presence of systemic comorbidities, fundus lesions or measurable improvement on Cirrus optical coherence tomography (OCT) between the first and last visit. RESULTS: After a mean follow-up of 15.5 months (4.7-27.8 interquartile range), central retinal thickness (CRT) (RR: 1.004; IC 95%: 1.001-1.007; P=0.011) and macular hemorrhage (RR: 0.30; IC 95%: 0.10-0.90, P=0.032) at baseline were found to be useful predictive factors for visual acuity improvement (≥15 letters) in patients treated for nAMD by anti-VEGF in a real world clinical setting. CONCLUSION: In the present series of patients with nAMD receiving a loading dose of bevacizumab and followed according to a PRN regimen for 24 months, the only predictable factors for a ≥15 letter gain in visual acuity were anatomical response as measured by OCT and macular hemorrhage at baseline.


Asunto(s)
Inhibidores de la Angiogénesis/administración & dosificación , Bevacizumab/administración & dosificación , Degeneración Macular/tratamiento farmacológico , Agudeza Visual , Anciano , Anciano de 80 o más Años , Inhibidores de la Angiogénesis/efectos adversos , Bevacizumab/efectos adversos , Biomarcadores Farmacológicos/análisis , Femenino , Humanos , Inyecciones Intravítreas , Degeneración Macular/diagnóstico , Degeneración Macular/epidemiología , Masculino , Neovascularización Patológica/diagnóstico , Neovascularización Patológica/tratamiento farmacológico , Neovascularización Patológica/epidemiología , Pautas de la Práctica en Medicina/estadística & datos numéricos , Pronóstico , Estudios Retrospectivos , Resultado del Tratamiento , Factor A de Crecimiento Endotelial Vascular/antagonistas & inhibidores , Factor A de Crecimiento Endotelial Vascular/inmunología
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