Real-world Treatment Outcomes of Age-related Macular Degeneration and Polypoidal Choroidal Vasculopathy in Asians

Purpose To describe the 12-month outcomes of treatment-naive eyes with choroidal neovascularization from age-related macular degeneration (AMD-CNV) and polypoidal choroidal vasculopathy (PCV) following initiation of intravitreal anti-VEGF monotherapy or combination therapy with verteporfin photodynamic therapy (PDT). Design A 12-month single-center, retrospective, comparative, nonrandomized cohort study. Participants Patients with AMD-CNV or PCV initiated on intravitreal anti-VEGF during 2015. Methods Demographics, visual outcomes, optical coherence tomography (OCT), and treatment data were collected at baseline and months 1, 3, 6, and 12 following treatment initiation. Multivariable analysis was performed to identify baseline features predictive of visual maintenance and improvement after 12 months of treatment. Main outcome measures Primary endpoint was VA change from baseline to month 12. Secondary end points were treatment exposure and change in central subfield thickness on OCT. Results A total of 364 patients (165 AMD-CNV and 199 PCV) were included. Baseline vision was 41 and 43 LogMAR letters for AMD-CNV and PCV cases, respectively. AMD-CNV and PCV cases received 5.5 and 5.3 injections (5.0 monotherapy vs. 5.6 combination therapy; mean of 1.2 PDTs), respectively. AMD-CNV patients gained 4.7 LogMAR letters after 12 months (p = 0.002), while PCV patients gained 6.6 (p = 0.001) and 10.8 LogMAR letters (p Conclusions In Asian patients, treatment of AMD-CNV with anti-VEGF yielded 12-month visual outcomes comparable to other real-world studies from Western populations, but poorer than controlled trials. In contrast, for PCV eyes, anti-VEGF monotherapy and combination therapy with PDT yielded comparable outcomes to controlled clinical trials.