Table 3.
Summary of Predictive Factors, Their Effects on Visual Outcomes Following Anti-VEGF Treatment and the Level of Supporting Evidence Within the Literature
| Baseline Factors | Level of Evidence (Strong, Insufficient or Mixed) | Relationship with VA After Anti-VEGF Treatment |
|---|---|---|
| Functional | ||
| Visual acuity | Strong | ● Patients presenting with lower VA gain more VA during treatment but are more likely to respond poorly ● Those with good initial VA are more likely to maintain good final VA in both the short and long term |
| Demographic | ||
| Gender | Insufficient | - |
| Age | Strong | ● Older age is associated with worse visual outcomes |
| Ethnicity | Insufficient | - |
| Systemic disease | Insufficient | - |
| Social habits | Mixed | ● Current and previous smoking status may be associated with worse visual outcomes |
| Genetics | Mixed | ● The presence of certain AMD risk alleles (CFH & ARMS2) and VEGF polymorphisms may influence visual response |
| Anatomic | ||
| CNV lesion type | Mixed | ● Classic & pre-dominantly classic lesions may be associated with worse visual outcomes due to worse presenting VA. |
| CNV lesion size | Strong | ● A larger lesion size is associated with lower VA gains |
| Retinal thickness | Mixed | ● Markedly thinner or thicker retinas associated with worse VA gain ● Fluctuations in thickness are associated with less VA gain and higher risk of atrophy |
| Retinal exudation | Mixed | ● IRF (particularly sub-foveal) associated with worse visual outcomes ● SRF at baseline associated with better VA gains, residual SRF associated with poorer outcomes |
| Pigment epithelial detachments | Mixed | ● Presence of PED at baseline associated with worse visual outcomes ● Response of PED not associated with VA gain |
| Atrophy | Mixed | ● Presence of macular atrophy associated with worse long-term VA gain |
| Hemorrhage | Mixed | ● Sub-retinal hemorrhage may lead to worse visual outcomes through scar formation |
Abbreviations: AMD, age-related macular degeneration; VA, visual acuity; VEGF, vascular endothelial growth factor; IRF, intraretinal fluid; SRF, subretinal fluid; PED, pigment epithelial detachment.