title: Remission and dropout rate of anti-VEGF therapy for age-related macular degeneration.
abstract: OBJECTIVE
  Anti-vascular endothelial growth factor (VEGF) therapy is a first-line treatment for age-related macular degeneration (AMD) but frequent visits and injections can be a burden for patients. The purpose of this study is to estimate the remission rate and tolerability of anti-VEGF therapy for AMD in a clinical setting.
  
  
  METHODS
  We investigated 90 eyes of 87 patients with AMD who underwent anti-VEGF therapy and were followed for more than 6 months. Ranibizumab and pegaptanib were used as anti-VEGF agents. Initial therapy was any of the following: a single injection, 3 consecutive monthly injections, or combination therapy with verteporfin. Additional injections were given as-needed during follow-up. An injection-free period greater than 6 months at the final observation was regarded as cessation; the reason for cessation was studied for each patient. Clinical characteristics were compared between patents with and without cessation.
  
  
  RESULTS
  The mean follow-up period was 12.8 months. Mean logMAR before and 6 months after the treatment was 0.89 and 0.83, respectively. Cessation was noted in 32 eyes of 31 patients (35.6%). Remission was achieved in 13 (40.6%) of these eyes. The other cases either did not wish to undergo further treatment or dropped out. Poor baseline visual acuity (VA) was associated with cessation.
  
  
  CONCLUSIONS
  With current anti-VEGF therapy, remission was achieved in a limited number of AMD cases. The high frequency of voluntary cessation warrants consideration of an alternative treatment and/or supportive care for those with poor baseline VA.
authors.affiliation: Department of Ophthalmology, Kobe City Medical Center General Hospital, Kobe, Japan. aquio@kuhp.kyoto-u.ac.jp
authors.forename: Akio
authors.initials: A
authors.lastname: Oishi
authors.forename: Michiko
authors.initials: M
authors.lastname: Mandai
authors.forename: Akihiro
authors.initials: A
authors.lastname: Nishida
authors.forename: Masayuki
authors.initials: M
authors.lastname: Hata
authors.forename: Takaaki
authors.initials: T
authors.lastname: Matsuki
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Kurimoto
mesh_terms: D000368:Aged; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D052157:Aptamers, Nucleotide / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D058449:Intravitreal Injections; D008268:Macular Degeneration / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D010352:Patient Dropouts / Q000706:statistics & numerical data*; D010778:Photochemotherapy; D000069579:Ranibizumab; D012074:Remission Induction; D012189:Retrospective Studies; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors*; D014792:Visual Acuity / Q000502:physiology
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D052157:Aptamers, Nucleotide; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; C495058:pegaptanib; D000069579:Ranibizumab