Stem MS, et al. - Authors undertook a comparison of the visual outcomes of eyes with established, active neovascular age-related macular degeneration (nvAMD) in index eyes with outcomes of fellow eyes that subsequently developed choroidal neovascularization (CNV) during the management protocol. Better visual acuity (VA) could be achieved in the fellow eyes of previously treated patients with nvAMD compared to their index eye counterparts after an equivalent amount of follow-up. This could possibly be due to the fact that CNV was detected and treated earlier and at a better level of VA.

Methods

• The scheme of this research was a retrospective single-center case series conducted at a private vitreoretinal practice.
• All patients treated for bilateral nvAMD between October 1, 2015, and October 1, 2016, for whom we could determine the date of index eye and fellow eye conversion to nvAMD (n = 1,600) were analyzed.
• Per institutional protocol, patients were screened for new CNV in the fellow eye at every office visit.
• Exclusion criteria included patients if they had a condition that could result in marked asymmetric vision loss.
• As a part of the exposures, the development of nvAMD was included.
• Visual acuity (VA) at the time of diagnosis of nvAMD and at equivalent time points following conversion to nvAMD for both index eyes and fellow eyes served as the main outcome.

Results

• A total of 264 patients met the inclusion criteria; 197 (74.6%) were women and 253 (95.8%) were white, and the mean (SD) age was 79.1 (8.2) years at time of index eye conversion to nvAMD and 80.6 (8.2) years at time of fellow eye conversion to nvAMD.
• It was determined that fellow eyes presented with better VA (mean VA, 20/50 [0.40 logMAR]) compared with index eyes (mean VA, 20/90 [0.67 logMAR]) at the time of conversion (difference, 14 letters [0.27 logMAR]; 95% CI, 10-17 [0.20-0.34]; P < .001).
• Findings displayed that index eyes did not achieve the same level of VA as fellow eyes after an equivalent postconversion follow-up of approximately 20 months (mean VA: index eye; 20/70 [0.56 logMAR]; fellow eye, 20/50 [0.40 logMAR]; difference, 8 letters [0.15 logMAR]; 95% CI, 4-11 [0.08-0.22]; P < .001).
• Data did not exhibit any variation between the mean number of anti-vascular endothelial growth factor injections received by fellow eyes and index eyes (9.7 vs 10.0 injections, respectively).