Short-term Outcomes of Anti-VEGF therapy in Neovascular Age-related Macular Degeneration with Initially Low Visual Acuity

Purpose : To study the short-term outcomes of anti-VEGF therapy in neovascular age-related macular degeneration (nAMD) in patients with initially low visual acuity. Patients and methods . Treatment-naive nAMD patients with best-corrected visual acuity (BCVA) less than 0.1 were included. All participants received three monthly injections of brolucizumab. Outcome measures were evaluated at two months after the last injection. At the beginning and at the end of the follow-up, all patients received standard ophthalmic examination and optical coherence tomography (OCT) to assess anatomical changes in the macula. Results . The study included 23 eyes (17 males and 6 females, 79.2 ± 7.1 years). During the study period, BCVA changed from 1.47 ± 0.36 to 1.36 ± 0.31 LogMAR (p = 0.77), central retinal thickness decreased from 393.1 ± 159.8 to 348.3 ± 199.2 µ m (p = 0.11). Macular volume decreased from 7.3 to 6.0 mm3 (p < 0.05). Severe morphological changes of the macula were found at baseline, including retinal pigment epithelium atrophy, subretinal fibrosis, giant intraretinal cysts and/or subretinal hemorrhages. Conclusion . Patients with nAMD, low visual acuity, and severe anatomical changes in the macula have a very limited or no benefits from anti-VEGF therapy.