title: Baseline Predictors for Good Versus Poor Visual Outcomes in the Treatment of Neovascular Age-Related Macular Degeneration With Intravitreal Anti-VEGF Therapy.
abstract: OBJECTIVE
  To examine the baseline factors associated with good (20/60 or better) versus poor (20/200 or worse) visual outcomes in eyes with treatment-naïve neovascular age-related macular degeneration (AMD) receiving intravitreal antivascular endothelial growth factor (VEGF) on a treat-and-extend regimen (TER).
  
  
  METHODS
  An observational, retrospective series of patients managed with a TER, identified as having either good or poor visual outcomes, was examined. A multivariate regression analysis of baseline characteristics identified factors associated with good and poor vision at 2, 3, and 4 years. Neovascular subtypes were identified using fluorescein angiography (FA) alone and the anatomic classification system with FA and optical coherence tomography (OCT).
  
  
  RESULTS
  One hundred thirty-eight patients (154 eyes) fit the inclusion criteria at 2 years, 106 patients (113 eyes) at 3 years, and 72 patients (74 eyes) at 4 years. In the multivariate analysis, type 1 lesions, according to anatomic classification, had better vision at 24 months (95% CI: [3.1, 82.7], P = 0.01), 36 months (95% CI: [1.97, 24.17], P = 0.003), and 48 months (95% CI: [2.01, 65.47], P = 0.006). Clopidogrel use was associated with poor vision at 24 months (95% CI: [0.03, 0.68], P = 0.013). Vision at 3 months was the best predictor of vision at year 4 (β = -4.277, P = 0.002).
  
  
  CONCLUSIONS
  Eyes with neovascular AMD managed with a TER of anti-VEGF therapy having type 1 neovascularization at baseline were more likely to maintain good vision over 4 years, whereas clopidogrel use predicted poor vision at 2 years. Vision at 3 months was the best predictor for favorable long-term vision.
authors.affiliation: Department of Ophthalmology New York University School of Medicine, New York, New York, United States 2Vitreous Retina Macula Consultants of New York, New York, New York, United States.
authors.forename: Bora
authors.initials: B
authors.lastname: Chae
authors.affiliation: Department of Ophthalmology New York University School of Medicine, New York, New York, United States 2Vitreous Retina Macula Consultants of New York, New York, New York, United States 3LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear and Thr.
authors.forename: Jesse J
authors.initials: JJ
authors.lastname: Jung
authors.affiliation: Vitreous Retina Macula Consultants of New York, New York, New York, United States 3LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear and Throat Hospital, New York, New York, United States.
authors.forename: Sarah
authors.initials: S
authors.lastname: Mrejen
authors.affiliation: Vitreous Retina Macula Consultants of New York, New York, New York, United States 3LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear and Throat Hospital, New York, New York, United States 5Department of Ophthalmology, University and Polytechni.
authors.forename: Roberto
authors.initials: R
authors.lastname: Gallego-Pinazo
authors.affiliation: Weill Cornell Medical College, New York, New York, United States.
authors.forename: Nicolas A
authors.initials: NA
authors.lastname: Yannuzzi
authors.affiliation: Weill Cornell Medical College, New York, New York, United States.
authors.forename: Samir N
authors.initials: SN
authors.lastname: Patel
authors.affiliation: Vitreous Retina Macula Consultants of New York, New York, New York, United States 3LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear and Throat Hospital, New York, New York, United States 7Department of Surgery, Monash University, Melbourne, A.
authors.forename: Christine Y
authors.initials: CY
authors.lastname: Chen
authors.affiliation: Vitreous Retina Macula Consultants of New York, New York, New York, United States 3LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear and Throat Hospital, New York, New York, United States 4Edward S. Harkness Eye Institute, Columbia University.
authors.forename: Marcela
authors.initials: M
authors.lastname: Marsiglia
authors.affiliation: Department of Ophthalmology New York University School of Medicine, New York, New York, United States.
authors.forename: Sucharita
authors.initials: S
authors.lastname: Boddu
authors.affiliation: Department of Ophthalmology New York University School of Medicine, New York, New York, United States 2Vitreous Retina Macula Consultants of New York, New York, New York, United States 3LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear and Thr.
authors.forename: K Bailey
authors.initials: KB
authors.lastname: Freund
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage*; D000068258:Bevacizumab; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D005654:Fundus Oculi; D006801:Humans; D058449:Intravitreal Injections; D008268:Macular Degeneration / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D008297:Male; D011379:Prognosis; D015861:Retinal Neovascularization / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors*; D014792:Visual Acuity
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab