Table 2.
Summary from Major Real-World Studies Investigating Predictors of Visual Outcomes in Anti-VEGF Treated Patients
| Author (Year) | Study | N (Eyes) | Treatment | Duration (Years) | Findings and Significant Factors | Non-Significant Factors |
|---|---|---|---|---|---|---|
| Holz (2016)50 | AURA | 1184 | RBZ | 2 | ● Higher baseline VA (−0.42 per letter) and older age (−0.28 per year) associated with less VA gains ● Higher # of ophthalmoscopies and OCT’s (+0.13 per observation) and higher total injections (+0.32 per injection) associated with better VA gains ● Age, baseline VA and # of ophthalmoscopies and OCT associated with VA maintenance (<15 letters) ● Age, baseline VA and # of injections associated with ≥15 letter gains |
- |
| Fasler (2019)118 | MEH | 3357 | AFL or RBZ | 2 | ● Younger age, lower baseline VA and more injections were associated with higher VA gains | ● Gender |
| Nguyen V (2019)39 | FRB | 2051 | Any anti-VEGF | 3 | ● Eyes with VA >70 letters by the 4th injection were more likely to have final VA >70 letters (OR: 9.8) ● VA change at 4th injection correlated more strongly with final VA (R2=0.37) than baseline VA (R2=0.20) |
- |
| Nguyen CL (2019)37 | FRB | 856 | Any anti-VEGF | 5 | ● Older age (OR: 1.33, >80 vs ≤80 years), lower total number of injections (OR: 0.97 per injection) and a higher proportion of visits with active CNV (OR: 1.97 upper vs lower quartile) were associated with sustained ≥15 letter VA loss ● Older age (OR: 1.64, >80 vs ≤80 years), lower baseline VA (OR: 1.64, ≤70 vs > 70 letters), lower total number of injections (OR: 0.96 per injection) and a higher proportion of visits with active CNV (OR: 2.22 upper vs lower quartile) were associated with sustained ≥30 letter VA loss ● Eyes with sustained VA loss were more likely to have haemorrhage, RPE tears, GA and subretinal fibrosis |
● Lesion type ● GLD |
| Fu (2020)28 | MEH | 7802 | AFL or RBZ | ~19 months | ● Better baseline VA associated with an increased likelihood of achieving 20/40 (HR: 1.43 per 5 letters) ● Higher # of injections associated with an increased likelihood of achieving 20/40 (HR: 1.12 per injection) ● Older patients were less likely to achieve 20/40 (HR: 0.88 per 5 years) ● Baseline VA, injection # and age also associated with the ability to maintain 20/40 or better ● Those who had an incomplete loading phase less likely to achieve 20/40 (HR: 0.87) and more likely to have final VA 20/400 or worse ● Those on RBZ more likely to have final VA 20/400 or worse |
● Drug choice (for good visual outcomes) ● Sex ● Ethnicity |
| Ho (2020)32 | IRIS | 162,902 | Any anti-VEGF | 2 | ● Eyes with worse baseline VA had larger VA gains but worse final VA | - |
| Schroeder (2020)127 | SMR | 6142 | Any anti-VEGF | 2 | ● Those with worse baseline VA, worse-seeing eye treated, older age, larger CNV lesion size at baseline and treated by RBZ or BVZ monotherapy were more likely to have final VA of ≤ 35 letters | ● Sex ● Lesion type and location ● Symptom duration |
Abbreviations: AFL, aflibercept; RBZ, ranibizumab; BVZ, bevacizumab; VEGF, vascular endothelial growth factor; CNV, choroidal neovascularization; OCT, optical coherence tomography; GLD, greatest linear dimension; RPE, retinal pigment epithelium; GA, geographic atrophy; VA, visual acuity.