Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2012, 156(4):359-364 | DOI: 10.5507/bp.2012.100

Effects of treatment change in patients with neovascular age-related macular degeneration; Results from the Czech National Registry

Jan Studnickaa, Eva Rencovaa, Pavel Rozsivala, Jaroslava Dusovaa, Zora Dubskab, Oldrich Chrapekc, Petr Kolard, Vit Kandrnale, Sarka Pitrovaf, Jiri Rehakc
a Department of Ophthalmology, Faculty of Medicine in Hradec Kralove, Charles University in Prague and University Hospital in Hradec Kralove, Czech Republic
b Department of Ophthalmology, 1st Faculty of Medicine, Charles University in Prague and General University Hospital in Prague
c Department of Ophthalmology, University Hospital Olomouc
d Department of Ophthalmology, University Hospital Brno
e Institute of Biostatistics and Analyses, Faculty of Medicine and Faculty of Science, Masaryk University Brno
f Private Eye Clinic, Prague

Aims: To determine the effectiveness of second line treatments in patients with neovascular AMD who did not respond adequately to primary treatment.

Methods: Retrospective, multicentre assessment. The frequency of primary treatment failure and outcomes of subsequent secondary treatment were assessed according to the type of primary treatment, type of CNV and change in BCVA over a 12 month period.

Results: At the time of assessment 750 entries (750 treated eyes, 725 treated patients) had follow-up longer than 12 months. A treatment change required 7.7% subjects treated with ranibizumab, 20.5% with pegaptanib and 22% with PDT and verteporfin. Average BCVA of all patients at the beginning of primary treatment was 50.7 ± 3 letters and 43 ± 3.5 letters in 12th month (P<0.001). The mean decrease in BCVA was 7.7 ± 0.6 letters during the first 6 months of observation. During the next 6 months, no significant change occurred. The change of primary therapy was required on average after 6.5 ± 2.1 months.

Conclusion: BCVA loss was the most significantly decelerated in patients who received ranibizumab as a secondary therapy following unsuccessful treatment with pegaptanib sodium.

Keywords: age-related macular degeneration, choroidal neovascular membrane, visual acuity, ranibizumab, pegaptanib, photodynamic therapy with verteporfin

Received: June 18, 2012; Accepted: October 22, 2012; Prepublished online: November 28, 2012; Published: December 12, 2012  Show citation

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Studnicka, J., Rencova, E., Rozsival, P., Dusova, J., Dubska, Z., Chrapek, O., ... Rehak, J. (2012). Effects of treatment change in patients with neovascular age-related macular degeneration; Results from the Czech National Registry. Biomedical papers, 156(4), 359-364. doi: 10.5507/bp.2012.100
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References

  1. Seddon JM, Chen CA. The epidemiology of age-related macular degeneration. Int Ophthalmol Clin 2004;44:17-39. Go to original source... Go to PubMed...
  2. Ferris FL III, Fine SL, Hyman L. Age-related macular degeneration and blindness due to neovascular maculopathy. Arch Ophthalmol 1984;102:1640-2. Go to original source... Go to PubMed...
  3. Wong T, Chakravarthy U, Klein R, Mitchell P, Zlateva G, Buggage R, Fahrbach K, Probst C, Sledge I. The natural history and prognosis of neovascular age-related macular degeneration. Ophthalmology 2008;115: 116-26. Go to original source... Go to PubMed...
  4. Ng EW, Shima DT, Calias P, Cunningham ET Jr, Guyer DR, Adamis AP. Pegaptanib sodium, a targeted anti-VEGF aptamer for ocular vascular disease. Nat Rev Drug Discov 2006;5:123-32. Go to original source... Go to PubMed...
  5. Lowe J, Araujo J, Yang J, Reich M, Oldendorp A, Shin V, Quarmby V, Lowman H, Lien S, Gaudreault J, Maia M. Ranibizumab inhibits multiple forms of biologically active vascular endothelial growth factor in vitro and in vivo. Exp Eye Res 2007;85:425-30. Go to original source... Go to PubMed...
  6. Treatment of age-related macular degeneration with photodynamic therapy (TAP) Study Group. Photodynamic therapy of subfoveal choroidal neovascularization in age-related macular degeneration with verteporfin: one-year results of 2 randomized clinical trials - TAP report. Arch Ophthalmol 1999;117:1329-45. Go to PubMed...
  7. Holz FG, Amoaku W, Donate J, Guymer RH, Kellner U, Schlingemann RO, Weichselberger A, Staurenghi G. Safety and efficacy of a flexible dosing regimen of ranibizumab in neovascular age-related macular degeneration: the SUSTAIN study. Ophthalmology 2011;118:663-71. Go to original source... Go to PubMed...
  8. Fung AE, Lalwani GA, Rosenfeld PJ, Dubovy SR, Michels S, Feuer WJ, Puliafito CA, Davis JL, Flynn HW Jr, Esquiabro M. An optical coherence tomography-guided, variable dosing regimen with intravitreal ranibizumab (Lucentis) for neovascular age-related macular degeneration. Am J Ophthalmol 2007; 143:566-83. Go to original source... Go to PubMed...
  9. Gragoudas ES, Adamis AP, Cunningham ET Jr, Feinsod M, Guyer DR. Pegaptanib sodium for neovascular age-related macular degeneration. N Engl J Med 2004;351:2805-16. Go to original source... Go to PubMed...
  10. Quiram PA, Hassan TS, Williams GA. Treatment of naive lesions in neovascular age-related macular degeneration with pegaptanib sodium. Retina 2007; 27:851-6. Go to original source... Go to PubMed...