title: Effects of treatment change in patients with neovascular age-related macular degeneration; results from the Czech National Registry.
abstract: OBJECTIVE
  To determine the effectiveness of second line treatments in patients with neovascular AMD who did not respond adequately to primary treatment.
  
  
  METHODS
  Retrospective, multicentre assessment. The frequency of primary treatment failure and outcomes of subsequent secondary treatment were assessed according to the type of primary treatment, type of CNV and change in BCVA over a 12 month period.
  
  
  RESULTS
  At the time of assessment 750 entries (750 treated eyes, 725 treated patients) had follow-up longer than 12 months. A treatment change required 7.7% subjects treated with ranibizumab, 20.5% with pegaptanib and 22% with PDT and verteporfin. Average BCVA of all patients at the beginning of primary treatment was 50.7 ± 3 letters and 43 ± 3.5 letters in 12(th) month (P<0.001). The mean decrease in BCVA was 7.7 ± 0.6 letters during the first 6 months of observation. During the next 6 months, no significant change occurred. The change of primary therapy was required on average after 6.5 ± 2.1 months.
  
  
  CONCLUSIONS
  BCVA loss was the most significantly decelerated in patients who received ranibizumab as a secondary therapy following unsuccessful treatment with pegaptanib sodium.
authors.affiliation: Department of Ophthalmology, Faculty of Medicine in Hradec Kralove, Charles University in Prague and University Hospital in Hradec Kralove, Czech Republic.
authors.forename: Jan
authors.initials: J
authors.lastname: Studnicka
authors.forename: Eva
authors.initials: E
authors.lastname: Rencova
authors.forename: Pavel
authors.initials: P
authors.lastname: Rozsival
authors.forename: Jaroslava
authors.initials: J
authors.lastname: Dusova
authors.forename: Zora
authors.initials: Z
authors.lastname: Dubska
authors.forename: Oldrich
authors.initials: O
authors.lastname: Chrapek
authors.forename: Petr
authors.initials: P
authors.lastname: Kolar
authors.forename: Vit
authors.initials: V
authors.lastname: Kandrnal
authors.forename: Sarka
authors.initials: S
authors.lastname: Pitrova
authors.forename: Jiri
authors.initials: J
authors.lastname: Rehak
mesh_terms: D000368:Aged; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D052157:Aptamers, Nucleotide / Q000627:therapeutic use*; D018153:Czech Republic; D005260:Female; D006801:Humans; D008268:Macular Degeneration / Q000188:drug therapy*; D008297:Male; D000069579:Ranibizumab; D012042:Registries; D012189:Retrospective Studies; D017211:Treatment Failure
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D052157:Aptamers, Nucleotide; C495058:pegaptanib; D000069579:Ranibizumab