A 5-Year Analysis of Optical Coherence Tomography Biomarkers in The Visual Outcomes of an As-Needed Treatment Algorithm for Neovascular Age-Related Macular Degeneration

OBJECTIVES: This study aimed to predict the visual course of patients with neovascular age-related macular degeneration by analyzing data from a 5-year observational study and to identify biomarkers that have an impact on visual prognosis.
METHODS: The present study comprised a total of 104 patients who received the PRN treatment regimen between March 2015 and March 2021. Best-corrected visual acuity (BCVA) and optical coherence tomography findings were evaluated. Multinomial logistic regression models were used to determine predictors of BCVA at 12, 24, and 60 months.
RESULTS: Better BCVA and thicker macula at baseline, decreased BCVA at month 3, and persistence of IRF at month 3 were correlated with decreased BCVA at month 12 (all p<0.05). At 24 month, a decline in BCVA was associated with specific baseline characteristics, including better BCVA, absence of pigment epithelial detachment (PED), and presence of intraretinal cystoid fluid (IRF) (all p<0.01). Similarly, decreased BCVA and thicker macula in the 3rd month were associated with worse BCVA. At the 60-month visit, better baseline BCVA, absence of PED, presence of IRF at baseline, and persistence of IRF at month 3 were associated with a reduction in BCVA (all p<0.05). The visual prognosis had no correlation with the number of injections.
DISCUSSION AND CONCLUSION: This 5-year real-life study identified prognostic markers that cause a decline in visual acuity. The use of these markers has the potential to be valuable in preserving visual gain, irrespective of the number of injections.

Keywords: Anti-vascular endothelial growth factor, Biomarkers, Neovascular age-related macular degeneration, Real-life, Visual prognosis