title: A prospective study of treatment patterns and 1-year outcome of Asian age-related macular degeneration and polypoidal choroidal vasculopathy.
abstract: OBJECTIVE
  To study the treatment patterns and visual outcome over one year in Asian patients with choroidal neovascular membrane secondary to age-related macular degeneration (AMD-CNV) and polypoidal choroidal vasculopathy (PCV).
  
  
  METHODS
  Prospective cohort, non-interventional study.
  
  
  METHODS
  132 treatment-naïve patients who received treatment for AMD-CNV and PCV were included. All patients underwent standardized examination procedures including retinal imaging at baseline and follow-up. AMD-CNV and PCV were defined on fundus fluorescein angiography and indocyanine green angiography at baseline. Patients were treated according to standard of care.We report the visual acuity (VA) and optical coherence tomography (OCT) measurements at baseline, month 3 and month 12 The factors influencing month 12 outcomes were analyzed.
  
  
  METHODS
  Type of treatment, number of Anti-vascular endothelial growth factor (VEGF) treatments, visual outcome over one year.
  
  
  RESULTS
  Anti-VEGF monotherapy was the initial treatment in 89.1% of AMD-CNV, but only 15.1% of PCV. The mean number of anti-VEGF injections up to month 12 was 3.97 (4.51 AMD-CNV, 3.43 PCV, p = 0.021). Baseline OCT, month 3 OCT and month 3 VA were significant in determining continuation of treatment after month 3. At month 12, mean VA improved from 0.82 (∼20/132) at baseline to 0.68 (∼20/96) at month 12 (mean gain 6.5 ETDRS letters, p = 0.002). 34.2% of eyes (38/113 eyes) gained ≥15 ETDRS letters and 14.4% (16/113 eyes) lost ≥15 ETDRS letters. There were no significant differences in visual outcome between AMD-CNV and PCV (p = 0.51). Factors predictive of month 12 visual outcome were baseline VA, baseline OCT central macular thickness, month 3 VA and age.
  
  
  CONCLUSIONS
  There is significant variation in treatment patterns in Asian eyes with exudative maculopathy. There is significant visual improvement in all treatment groups at one year. These data highlight the need for high quality clinical trial data to provide evidence-based management of Asian AMD.
authors: Vitreoretinal Service, Singapore National Eye Centre, Singapore, Singapore; Singapore Eye Research Institute, Singapore, Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; Ophthalmology Academic Clinical Program, Duke-NUS Graduate Medical School, Singapore, Singapore.
authors: Chui Ming Gemmy
authors: CM
authors: Cheung
authors: Singapore Eye Research Institute, Singapore, Singapore; Department of Statistics and Applied Probability, National University of Singapore, Singapore, Singapore.
authors: Xiang
authors: X
authors: Li
authors: Vitreoretinal Service, Singapore National Eye Centre, Singapore, Singapore.
authors: Ranjana
authors: R
authors: Mathur
authors: Vitreoretinal Service, Singapore National Eye Centre, Singapore, Singapore.
authors: Shu Yen
authors: SY
authors: Lee
authors: Vitreoretinal Service, Singapore National Eye Centre, Singapore, Singapore.
authors: Choi Mun
authors: CM
authors: Chan
authors: Vitreoretinal Service, Singapore National Eye Centre, Singapore, Singapore.
authors: Ian
authors: I
authors: Yeo
authors: Vitreoretinal Service, Singapore National Eye Centre, Singapore, Singapore.
authors: Boon Kwang
authors: BK
authors: Loh
authors: Worldwide Epidemiology, R&D Projects, Clinical Platforms & Sciences, GlaxoSmithKline, Pennsylvania, United States of America.
authors: Rachel
authors: R
authors: Williams
authors: Vitreoretinal Service, Singapore National Eye Centre, Singapore, Singapore.
authors: Edmund Yick-Mun
authors: EY
authors: Wong
authors: Vitreoretinal Service, Singapore National Eye Centre, Singapore, Singapore.
authors: Doric
authors: D
authors: Wong
authors: Vitreoretinal Service, Singapore National Eye Centre, Singapore, Singapore; Singapore Eye Research Institute, Singapore, Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; Ophthalmology Academic Clinical Program, Duke-NUS Graduate Medical School, Singapore, Singapore.
authors: Tien Yin
authors: TY
authors: Wong
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D044466:Asian People; D002829:Choroid / Q000187:drug effects / Q000378:metabolism / Q000473:pathology; D020256:Choroidal Neovascularization / Q000188:drug therapy* / Q000208:ethnology / Q000209:etiology / Q000378:metabolism; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D058449:Intravitreal Injections; D008268:Macular Degeneration / Q000150:complications / Q000188:drug therapy* / Q000208:ethnology / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012160:Retina / Q000187:drug effects / Q000378:metabolism / Q000473:pathology; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors / Q000378:metabolism
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A