Trends in Real-World Neovascular AMD Treatment Outcomes in the UK

Figures & data

Figure 1 Visual acuity (VA) outcomes of intravitreal anti-VEGF therapy for nAMD at baseline and 1 year. Only real-world studies with ≥100 eyes at baseline are included. The year of publication is later than the date of acquisition of data for all studies. Blue indicates ranibizumab treated eyes. Orange indicates aflibercept treated eyes. Grey indicates that combined data for ranibizumab and aflibercept treated eyes was reported. Green indicates mean visual gain from baseline. Red indicates mean visual loss from baseline.

Figure 2 Visual acuity (VA) outcomes of intravitreal anti-VEGF therapy for nAMD at baseline and 2 years. Only real-world studies with ≥100 eyes at baseline are included. The year of publication is later than the date of acquisition of data for all studies. Blue indicates ranibizumab treated eyes. Orange indicates aflibercept treated eyes. Green indicates mean visual gain from baseline. Red indicates mean visual loss from baseline.

Table 1 Percentage of Eyes Losing >15 Letters from Baseline VA

Study	>15 Letter Loss at End of Year 1	>15 Letter Loss at End of Year 2
Pushpoth et al 2012^Citation44	9.5	14.6
Ross et al 2013^Citation45	9.9	N/R
Muniraju et al 2013^Citation32	9.8	14.4
UK AMD EMR. 2014^Citation46	10	18
Basheer et al 2015^Citation22	8.1	11.5
Talks et al 2016^Citation36	8	N/A
Eleftheriadou et al 2018^Citation26	6.8	9.2
Chandra et al 2020^Citation41	5.6	13.3

Notes: It should be noted that baseline characteristics will be different between real-world studies and compared with registration clinical trials. The percentage of eyes losing >15 letters at 2 years was approximately 9% in the MARINA registration trial for ranibizumab. In the integrated analysis of 2-year VIEW 1 and 2 data, 7.6% of eyes lost >15 letters from baseline.

Abbreviations: N/R, not reported; N/A, not applicable.

Table 2 Percentage of Eyes with Driving Level VA at Baseline and 1 and 2-Year Follow-Up

Study	>70 Letters at Baseline	>70 Letters at Year 1	>70 Letters at Year 2
Pushpoth et al 2013*44	6.4%	31.3%	17.2%
Ross et al 201345	11.3%	–	–
Chavan et al 2014** 25	3.3%	6.7%	7.9%
Buckle et al 2016 24	16.9%	17.0%	15.9%
Talk et al 2016 36	16.4%	33.7%	–
Almuhtaseb et al 2017b 43	–	–	34%
Eleftheriadou et al 2018*** 26	10.8%	30.4%	38.9%
Fasler et al 2019 27	24%	42%	44%
Chandra et al 2020 41	32.2%	54.4%	50.3%

Notes: It should be noted that baseline characteristics will be different between real-world studies and compared with registration clinical trials. There is significant loss to follow-up over time in included real-world studies. *Study recorded greater than 75 logMAR letters and may have included some pre-treated eyes. **Study recorded greater than 75 logMAR letters. ***Study recorded greater than 73 letters that is equated to 6/12 Snellen in some clinical trials.

Figure 3 Mean VA gain at 1 year correlated with mean number of intravitreal anti-VEGF injections received. Only real-world studies with ≥100 eyes at baseline were included. It should be noted that a limitation is that there will be variation in baseline characteristics of included studies. Pearson correlation coefficient, r = 0.66 (p = 0.0095) indicating moderate positive correlation that is statistically significant.

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