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Functional and structural characteristics in patients with type 3 macular neovascularisation treated with anti-VEGF. Three-year results in real world settings

Eye (2024)Cite this article

Subjects

Abstract

Background

To evaluate the long-term anatomical and functional outcomes of anti-Vascular Endothelial Growth Factor intravitreal injections (anti-VEGF IVI) in patients with type 3 macular neovascularisation (MNV) in real-world settings.

Methods

Retrospective review of patients with type 3 MNV who received anti-VEGF IVI between 2013 and 2020. Primary outcomes were best corrected visual acuity (BCVA) and central macular thickness (CMT). Secondary outcome was the development of new-onset of foveal-involving geographic atrophy (GA) and disciform scars.

Results

We identified 59 eyes from 48 British patients that met the inclusion criteria. Treatment with anti- VEGF IVI resulted in a statistically significant reduction in median CMT, which was maintained throughout the study period. At 36 months, 24 eyes showed more than 50 μm reduction in CMT, 7 eyes remained stable and only 2 eyes showed an increase in CMT by more than 50μm compared to the baseline. At year three, deterioration was noticed in most eyes (52.78%) and vision remained stable or improved in 47.22% of the eyes. However, the median BCVA was not statistically significant different compared to baseline. During the study period new onset of macula-involving atrophy or scar was noted in 10.2% and 4.3% of the eyes, respectively.

Conclusion

In this real-world study, anatomic and functional improvement were recorded 12-months post anti-VEGF IVI in type 3 MNV. Despite sustained anatomical improvement, vision returned back to baseline levels at 36-months. The development of GA and macular scar was only partially responsible for this outcome suggesting a more severe nature of this form of nAMD.

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Fig. 1: Multimodal imaging 3 years follow up of a case with type 3 MNV.
Fig. 2: Changes in BCVA within 3 years follow up.

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Data availability

The data that support the findings of this study are available from the corresponding author, GDS, upon reasonable request.

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Author notes

  1. These authors contributed equally: Anastasios E. Sepetis, Ramez Barbara

Authors and Affiliations

  1. Department of Ophthalmology, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16 6YD, Hampshire, United Kingdom

    Anastasios E. Sepetis, Ramez Barbara, Mohamed Farag & Gabriella De Salvo

  2. Ophthalmology - Surgery Department, Guglielmo da Saliceto Hospital, Piacenza, Italy

    Rino Frisina

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Contributions

Conceptualisation: GDS; Methodology: AES, GDS, RB; Data Acquisition: AES, RB, MF; Data analysis and interpretation: AES, RB, GDS; Writing- original draft preparation: AES, RB, GDS; Writing- review and editing: AES, RF, GDS; Supervision: RF, GDS. All authors have read and agreed to the published version of the manuscript.

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Correspondence to Gabriella De Salvo.

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Sepetis, A.E., Barbara, R., Frisina, R. et al. Functional and structural characteristics in patients with type 3 macular neovascularisation treated with anti-VEGF. Three-year results in real world settings. Eye (2024). https://doi.org/10.1038/s41433-023-02918-w

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  • DOI: https://doi.org/10.1038/s41433-023-02918-w

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