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24.11.2017 | Retinal Disorders | Ausgabe 1/2018

Graefe's Archive for Clinical and Experimental Ophthalmology 1/2018

AREDS simplified severity scale as a predictive factor for response to aflibercept therapy for typical neovascular age-related macular degeneration

Zeitschrift:
Graefe's Archive for Clinical and Experimental Ophthalmology > Ausgabe 1/2018
Autoren:
Yoichi Sakurada, Wataru Kikushima, Atsushi Sugiyama, Seigo Yoneyama, Naohiko Tanabe, Mio Matsubara, Hiroyuki Iijima

Abstract

Purpose

To investigate whether the severity of the condition in the untreated fellow eye is a predictive factor for the response to intravitreal aflibercept injection (IAI) for exudative age-related macular degeneration (AMD).

Methods

A retrospective medical chart review was conducted for 88 patients with treatment-naïve neovascular AMD, who were initially treated with three monthly IAIs, followed by monthly monitoring and re-injection as needed for at least 12 months. Subjects were classified into three groups according to the severity of the condition in their untreated eye, based on the severity scale in the Age-Related Eye Disease Study (AREDS): group 0, AREDS severity level 1 (no drusen); group 1, AREDS severity level 2 or 3 (any drusen); group 2, AREDS severity level 4 (advanced AMD). Genotyping was performed in all cases for ARMS2 A69S and CFH I62V.

Results

Fellow-eye severity was associated with age and the risk variant of ARMS2 A69S (P = 0.005 and 0.001, respectively). Although best-corrected visual acuity (BCVA) had improved significantly after 12 months in all groups, this improvement was significantly greater in group 0 than in the other groups (P = 0.008). The retreatment-free period was also significantly longer for group 0 than for the other groups (P = 0.016), and the number of additional injections was significantly associated with fellow-eye severity (P = 0.007).

Conclusions

Fellow-eye severity was associated with treatment response in terms of visual improvement and retreatment and may be a predictive factor for response to IAI for neovascular AMD.

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