Clinical Ophthalmology (Aug 2021)
Predictors of Visual Acuity After Treatment of Neovascular Age-Related Macular Degeneration – Current Perspectives
Abstract
Long T Phan,1,2 Geoffrey K Broadhead,1,3 Thomas H Hong,1 Andrew A Chang1,3 1Sydney Retina, Sydney, New South Wales, Australia; 2Discipline of Orthoptics, University of Technology Sydney, Sydney, New South Wales, Australia; 3Save Sight Institute, The University of Sydney, Sydney, New South Wales, AustraliaCorrespondence: Andrew A ChangSydney Retina, Level 13, Park House, 187 Macquarie Street, Sydney, 2000, New South Wales, AustraliaTel +61 2 9221 3755Fax +61 2 9221 1637Email [email protected]: Visual acuity is a key outcome measure in the treatment of neovascular age-related macular degeneration (nAMD) using anti-vascular endothelial growth factor agents. Large variations in visual responses between individuals within clinical trials and real-world studies may relate to underlying differences in patient and treatment factors. Most notably, a better baseline visual acuity, younger age and smaller choroidal neovascularization lesion size have been strongly associated with achieving better visual outcomes. In addition, there is emerging evidence for other roles including genetic factors and anatomical variables such as fluid status. Apart from patient-related factors, treatments that favor a higher number of injections tend to provide better visual outcomes. Overall, the identification of predictive factors does not currently play an essential role in the clinical management of patients with nAMD. However, they have allowed for the understanding that early detection, timely management and close monitoring of the disease are required to achieve optimal visual outcomes. Further investigation into predictive factors alongside the development of novel therapeutic agents may one day provide a means to accurately predict patient outcomes. Treatment regimens that offer flexible dosing patterns such as the treat-and-extend strategy currently provide a degree of personalization during treatment.Keywords: age-related macular degeneration, anti-VEGF, visual acuity, demographic, genetic, anatomic
