Clinical Ophthalmology (Jan 2025)
One-Year Outcomes in Subjects Developing Macular Neovascularization While Undergoing Avacincaptad Pegol Therapy for Geographic Atrophy
Abstract
Ryan B Rush,1– 3 Westin Klein,1 Sloan W Rush,1,2 Robert Reinauer4 1Department of Ophthalmology, Panhandle Eye Group, Amarillo, TX, USA; 2Department of Surgery, Texas Tech University Health Science Center, Amarillo, TX, USA; 3Department of Ophthalmology, Southwest Retina Specialists, Amarillo, TX, USA; 4Department of Ophthalmology, New Vision Eye Center, Vero Beach, FL, USACorrespondence: Ryan B Rush, Southwest Retina Specialists, 7411 Wallace Blvd, Amarillo, TX, 79106, USA, Tel +1806 351 1870, Email [email protected]: To assess the 12-month outcomes in subjects developing macular neovascularization (MNV) during intravitreal avacincaptad pegol (IVA) treatment for geographic atrophy (GA) secondary to age-related macular degeneration (AMD).Methods: This research was conducted as a case-controlled, retrospective study of AMD subjects undergoing IVA treatment for GA from two private practice institutions. Subjects were divided into 1) a Study Group of patients who developed MNV and then underwent anti-vascular endothelial growth factor (VEGF) therapy during the study period, and 2) a Control Group of patients who were complication-free during the study period. Both cohorts had a baseline Snellen visual acuity of ≥ 20/200, a baseline GA total area of ≥ 1 mm2and ≤ 17.5 mm2, and 12 months of follow-up after initiation of IVA for GA.Results: There were 56 patients analyzed. There were no significant differences in baseline features between cohorts. The Study Group had a greater decrease in visual acuity [− 0.22 logMAR (− 0.27 to − 0.17) versus − 0.06 logMAR (− 0.12 to 0.00); p=< 0.0001], and greater GA total lesion growth [1.78 mm2 (1.53– 2.03) versus 0.78 mm2 (0.54– 1.02); p=< 0.0001] during the 12-month study period compared to the Control Group.Conclusion: Patients developing MNV while undergoing IVA treatment for GA secondary to AMD have worse clinical outcomes despite undergoing anti-VEGF therapy compared to patients who were complication-free at 12-months. This highlights the seriousness of MNV in this patient population and may help specialists counsel patients when considering treatment for GA secondary to AMD.Keywords: geographic atrophy, avacincaptad pegol, macular neovascularization, izervay, choroidal neovascularization, complement inhibition, age-related macular degeneration
