Initial treatment response can predict one-year treatment outcomes in neovascular age-related macular degeneration treated according to the observe-and-plan regimen

PURPOSE: To investigate if the initial treatment response can predict the 1-year treatment outcomes in patients with neovascular age-related macular degeneration (nAMD) treated according to the observe-and-plan (O&P) regimen.

METHODS: In this prospective cohort study, treatment-naïve patients with nAMD were enrolled consecutively and followed for 1 year while being treated according to the O&P regimen. The treatment response was determined initially post-loading doses and after 1 year. The functional treatment response (fTR) was determined by the change in best corrected visual acuity, while the morphological treatment response (mTR) was assessed by central retinal thickness and the presence of sub- and intraretinal fluid on optical coherence tomography and categorized as good, partial, and poor responders. The relative risk (RR) of the initial treatment response for predicting 1-year treatment response was assessed.

RESULTS: One hundred patients were included and 94 completed the 1-year follow-up. Patients with an initial good fTR and initial poor fTR had an RR of 4.1 (95% CI 1.8-9.2) and 4.3 (95% CI 2.2-8.3), respectively, of remaining in the same response category at 1 year. Similarly, patients with an initial good mTR and initial poor mTR had an RR of 3.0 (95% CI 1.8-4.8) and 8.7 (95% CI 3.0-25.1), respectively, of remaining in the same response category at 1 year.

CONCLUSIONS: Both the anatomic and visual functional response after 3 loading doses are predictive of the anatomic and functional outcomes at 1 year in patients with nAMD treated according to the O&P regimen.