Table 2.
Comparison with literature: visual acuity outcomes and self-reported injection frequency in eyes with neovascular age-related macular degeneration undergoing anti-VEGF therapy in randomized controlled trials and real-world observational studies.
| Current study | Randomized controlled trial data | Real-world data | |||||||
|---|---|---|---|---|---|---|---|---|---|
| AREDS2 | MARINA | ANCHOR | CATT | Meta-analysis (global data) | UK AMD EMR Users Group | LUMINOUS | IRIS Registry | ||
| Treatment regimen | Any drug Any regimen | Ranibizumab Fixed monthly | Ranibizumab Fixed monthly | Ranibizumab Fixed monthly | Ranibizumab PRN | Ranibizumab Predom. PRN | Ranibizumab Predom. PRN | Ranibizumab Any regimen | Any single drug Any regimen |
| Eyes at baseline (n) | 1105 | 478 | 280 | 301 | 298 | 24,178 | 12,951 | 3379 | 13,859 |
| Mean VA: ETDRS letters
(Snellen equivalent) Mean injections per year (n) | |||||||||
| Baseline | - | 53.7 (20/80) | 47.1 (20/120) | 59.9 (20/60) | 61.8 (20/60) | 53.6 (20/80) | 55 (20/80) | 51.9 (20/100) | 0.57 * (20/80) |
| 1 year | 68.0 (20/40) 2.9 † | 60.9 (20/60) 12 | 58.4 (20/60) 12 | 68.4 (20/40) 11.7 | 68.6 (20/40) 6.9 | 58.6 (20/60) 6.3 or 5.0 ** | 57 (20/80) Median 5 | 55.0 (20/80) 5.0 | 0.52 * (20/60) 6.1 |
| 2 years | 66.1 (20/50) 3.9 † | 60.3 (20/60) 12 | 57.8 (20/60) 12 | 68.7 (20/40) 22.4 over 2y | 68.5 (20/40) 12.6 over 2y | 57.0 (20/80) 4.4 or 3.8 ** | 56 (20/80) Median 4 | ||
| 3 years | 64.7 (20/50) 3.3 † | 54.7 (20/80) 3.3 or 3.8 ** | 53 (20/80) Median 4 | ||||||
| 5 years | 61.5 (20/60) 3.0 † | 58.9 (20/60) Mean 15.4 over mean 3.5y (after RCT exit); mean ‘4 to 5’ per year (CATT Follow-up Study, i.e. routine clinical care after RCT; n=647) |
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| 7 years | 45.7 (20/120) Mean 6.8 over mean 3.4y (after HORIZON exit); mean 1.6 per year (SEVEN-UP study, i.e. routine clinical care after RCT; n=65) |
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LogMAR VA
Mean self-reported number of injections per year
Random-effects estimate and weighted mean, respectively
ANCHOR=Anti-VEGF Antibody for the Treatment of Predominantly Classic Choroidal Neovascularization in Age-Related Macular Degeneration; AREDS2=Age-Related Eye Disease Study 2; CATT=Comparison of Age-Related Macular Degeneration Treatments Trial; ETDRS=Early Treatment of Diabetic Retinopathy Study; IRIS=Intelligent Research in Sight; MARINA=Minimally Classic/Occult Trial of the Anti-VEGF Antibody Ranibizumab in the Treatment of Neovascular Age-Related Macular Degeneration; PRN=Pro Re Nata; RCT=Randomized Controlled Trial; SEVEN-UP=Seven-Year Observational Update of Macular Degeneration Patients Post-MARINA/ANCHOR and HORIZON Trials; UK AMD EMR Users Group=United Kingdom Age-Related Macular Degeneration Electronic Medical Record Users Group