Anti–Vascular Endothelial Growth Factor Use and Atrophy in Neovascular Age-Related Macular Degeneration: Systematic Literature Review and Expert Opinion

摘要: Topic To summarize the rates of atrophy, risk factors, and atrophy-associated visual outcomes in patients with neovascular age-related macular degeneration (nAMD) who received anti–vascular endothelial growth factor (VEGF) treatment for neovascularization (MNV). Clinical Relevance Age-related is a leading cause vision loss worldwide, VEGF inhibitors are primary nAMD. However, atrophy observed frequently eyes treated anti-VEGF therapy, prompting questions regarding causative role these therapies development. Methods PubMed was searched articles published past 5 years (January 1, 2014, through January 10, 2019). Studies including outcome(s) were included. Review articles, retrospective studies, case reports or preclinical prevalence data reports, non-English studies excluded. Randomization not required. Results Overall, 145 identified; 29 publications included, cohorts ranging from 8 to 1185 eyes. Imaging methods used assess varied across studies. All confirmed occurrence when available, longitudinal included demonstrated an increase incidence over time. Key factors phenotypes associated fellow eye reticular pseudodrusen, increased injections, type 3 lesion. In addition, acuity noted foveal atrophy. Discussion that occurs context MNV therapy; however, it clear whether versus being The designed powered as outcome. difficult determine prognostic directly affect Furthermore, patient populations clinical trials do necessarily represent real-world patients. Although may help identify those at greater developing, important recognize adequately treating exudative remains best option optimize nAMD, particularly given undertreatment real world.