title: Outcomes of persistently active neovascular age-related macular degeneration treated with VEGF inhibitors: observational study data.
abstract: OBJECTIVE
  To describe outcomes of eyes with wet age-related macular degeneration (AMD) subdivided by lesion activity in a large multicentre cohort study.
  
  
  METHODS
  Treatment-naive eyes with subfoveal choroidal neovascularisation receiving antivascular endothelial growth factor therapy enrolled in the Fight Retinal Blindness observational study were included. Lesions were graded at each visit as active if there was intraretinal or subretinal fluid attributable to leak from choroidal neovascularisation lesion or fresh haemorrhage. Eyes were divided into four groups; based on the proportion of visits, each eye was graded as active during the first 12 months of treatment (persistent, high, moderate and low activity).
  
  
  RESULTS
  655 eyes were included. Similar mean visual acuity changes compared with baseline were observed in all four groups at 12 months (+6.8, +8.3, +6.2 and +5.5 letters for the low, moderate, high and persistent groups, respectively; p<0.001 for each group). The mean number of injections given increased only modestly in groups with more active lesions (7.6, 7.9, 8.4 and 8.3, respectively, p=0.015). Occult and minimally classic lesions were more frequent in the more active groups (p=0.024).
  
  
  CONCLUSIONS
  Persistent activity of neovascular lesions during 12 months after starting intravitreal therapy was not associated with worse visual outcomes in this observational study of AMD.
authors.affiliation: The Save Sight Institute, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia Department of Ophthalmology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
authors.forename: Daniel
authors.initials: D
authors.lastname: Barthelmes
authors.affiliation: The Save Sight Institute, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Richard
authors.initials: R
authors.lastname: Walton
authors.affiliation: The Save Sight Institute, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Anna E
authors.initials: AE
authors.lastname: Campain
authors.affiliation: Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Judy M
authors.initials: JM
authors.lastname: Simpson
authors.affiliation: Marsden Eye Specialists, Parramatta, New South Wales, Australia.
authors.forename: Jennifer J
authors.initials: JJ
authors.lastname: Arnold
authors.affiliation: The Lions Eye Institute, Perth, Western Australia, Australia.
authors.forename: Ian L
authors.initials: IL
authors.lastname: McAllister
authors.affiliation: Center for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia.
authors.forename: Robyn H
authors.initials: RH
authors.lastname: Guymer
authors.affiliation: The Save Sight Institute, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia Retina Associates, Chatswood, New South Wales, Australia.
authors.forename: Alex P
authors.initials: AP
authors.lastname: Hunyor
authors.affiliation: Department of Ophthalmology, Canberra Hospital, Garran, Australian Capital Territory, Australia.
authors.forename: Rohan W
authors.initials: RW
authors.lastname: Essex
authors.affiliation: Department of Population Health, University of Western Australia, Perth, Western Australia, Australia.
authors.forename: Nigel
authors.initials: N
authors.lastname: Morlet
authors.affiliation: The Save Sight Institute, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Mark C
authors.initials: MC
authors.lastname: Gillies
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects / Q000627:therapeutic use*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D000069579:Ranibizumab; D058471:Subretinal Fluid; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors*; D014792:Visual Acuity / Q000502:physiology; D057135:Wet Macular Degeneration / Q000188:drug therapy* / Q000503:physiopathology
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000069579:Ranibizumab
keywords: Macula; Neovascularisation; Retina; Vision