Original articleReal-World Vision in Age-Related Macular Degeneration Patients Treated with Single Anti–VEGF Drug Type for 1 Year in the IRIS Registry
Section snippets
Study Sample
This was a nonrandomized, retrospective, comparative review of patients with nAMD who received a single anti-VEGF drug (1.25 mg bevacizumab, 0.5 mg ranibizumab, or 2 mg aflibercept) for 1 year between January 1, 2013, and September 30, 2016. Individuals were part of the AAO IRIS Registry, the first US-based national comprehensive eye disease database. The IRIS Registry's electronic health record (EHR) base consisted of approximately 1790 ophthalmologist-based practices with 7791 participating
Participant Characteristics
A total of 204 749 patients were identified who underwent at least 3 intravitreal injections during the study period. Of those, 94 881 exhibited nAMD at the time of the first injection. Further exclusions consisted of those with an age <50 years (n = 800); those with fewer than 180 days of follow-up (n = 14 379); those with a history of anti-VEGF or steroid injection within 6 months of their first injection or prior ocular disease, photodynamic therapy, vitrectomy, or laser in the study eye
Discussion
We present the real-world VA results of treatment-naïve patients with nAMD who received a single anti-VEGF drug without switching for 1 year in a cohort of the AAO IRIS Registry. To date, this is the largest nonrandomized comparative review that compares VA outcomes among 3 anti-VEGF agents head-to-head in nAMD over 1 year in US clinical practice. We demonstrated that all 3 drugs improve VA after 1 year of monotherapy. However, there was no overall difference in the mean VA change between
References (19)
- et al.
Trends of anti-vascular endothelial growth factor use in ophthalmology among privately insured and Medicare Advantage patients
Ophthalmology
(2017) - et al.
VIEW 1 and VIEW 2 Study Groups. Intravitreal aflibercept (VEGF trap-eye) in wet age-related macular degeneration
Ophthalmology
(2012) - et al.
Efficacy and safety of monthly versus quarterly ranibizumab treatment in neovascular age-related macular degeneration: the EXCITE study
Ophthalmology
(2011) - et al.
Ranibizumab and bevacizumab for treatment of neovascular age-related macular degeneration two-year results
Ophthalmology
(2012) - et al.
Five-year outcomes with anti-vascular endothelial growth factor treatment of neovascular age-related macular degeneration: the Comparison of Age-Related Macular Degeneration Treatments Trials
Ophthalmology
(2016) - et al.
Serious adverse events with bevacizumab or ranibizumab for age-related macular degeneration: meta-analysis of individual patient data
Ophthalmol Retina
(2017) - et al.
Prevalence of age-related macular degeneration in the United States
Arch Ophthalmol
(2004) - et al.
Anti-vascular endothelial growth factor for neovascular age-related macular degeneration
Cochrane Database Syst Rev
(2014) - et al.
The natural history and prognosis of neovascular age-related macular degeneration: a systematic review of the literature and meta-analysis
Ophthalmology
(2008)
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Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.
HUMAN SUBJECTS: Data from the IRIS Registry are de-identified and do not require patient-level consent. Institutional review board approval was not required.
Submitted to American Academy of Ophthalmology Annual Meeting, November 11–14, 2017, New Orleans, Louisiana, and IRB/Ethics Committee ruled that approval was not required for this study.
Author Contributions:
Conception and design: Rao, Lum, Salman, Hall, Singh, Williams
Data collection: Rao, Lum, Wood, Williams
Analysis and interpretation: Rao, Lum, Wood, Salman, Burugapalli, Parke, Williams
Overall responsibility: Rao, Lum, Parke
Supplemental material available at www.aaojournal.org.