Real-life results in treating neovascular age-related macular degeneration with anti-VEGF therapy. Analysis of 122 patients from a single centre.

BACKGROUND: The prognosis of age-related macular degeneration (AMD) has improved significantly since the advent of antiangiogenic treatments. However, several «real life¼ studies have shown lower number of injections and a markedly worse visual prognosis than pivotal clinical trials. OBJECTIVE: To assess the effectiveness and safety of the treatment of neovascular AMD and analyse clinical factors related to the functional and structural prognosis in routine clinical practice. MATERIAL AND METHODS: Retrospective, observational, single-centre study that included 143 eyes of 122 patients diagnosed with neovascular AMD between the years 2015 and 2016, who received treatment with antiangiogenic drugs and were followed up for two or more years. RESULTS: Visual acuity improved in 45% of patients after two years of treatment. The mean decrease in central macular thickness was 85 µm (p < 0.001) and the mean number of injections was 13. Retinal pigment epithelium rupture was present in 3.5%. Ranibizumab was the drug most used as a first option, although 79 patients (55.2%) required a change in treatment, most being switched to aflibercept. A greater number of visits (p < 0.001) and a lower number of injections (p < 0.01) were predictors of worse structural outcome. The number of visits was associated with better visual acuity (p < 0.001). CONCLUSIONS: The treatment has demonstrated its efficacy by improving visual acuity and central macular thickness. However, the number of injections performed has generally been higher than in other real-life studies.

[Effects of ozurdex on intraocular pressure. A real life clinical practice study]. / Efectos de ozurdex en la presión intraocular. Estudio en la práctica clínica.

OBJECTIVE: The dexamethasone biodegradable implant, ozurdex, is approved by the US Food and Drug Administration and by the European Medical Agency for the treatment of intermediate and posterior uveitis, and for the treatment of macular edema following retinal vein occlusion and diabetic macular edema. The aim of this study was to assess the effects of intraocular pressure in a cohort of patients from a real-life clinical practice. METHODS: Retrospective review was performed on the clinical records of patients treated with Ozurdex in Hospital Universitario Cruces in a 6 month period. The following variables were recorded: age, gender, diagnosis and history of glaucoma; intraocular pressure, antihypertensive treatment and macular thickness were recorded before the injection, and in the 1st, 2nd, 4th, and 6th months after the injection. STATISTICAL TESTS: Mann-Whitney U test, Chi square test (with Fisher correction when needed) and Wilcoxon test. The level of statistical significance was set at P<.05. RESULTS: The effects of 75 injections given to 67 patients (35 women: 52%; mean age: 62) were evaluated. Mean intraocular pressure before the injection was 15.9 mmHg and at 1st, 2nd, 4th and 6th months after de injection it was 18.80 (P=.627), 18.84 (P=.494), 17.02 (P=.796) and 15.5 (P=.829), respectively. No statistically significant differences were observed in intraocular pressure measurements at the mentioned follow-up visits between patients with and without a history of glaucoma. CONCLUSIONS: In real-life clinical practice, ozurdex shows an excellent safety profile in terms of intraocular hypertension. Patients with a history of glaucoma may also show this profile, with ozurdex being a good option to treat retinal diseases in these patients.