Long-Term Observational Data on Neovascular Age-related Macular Degeneration: A 10-Year Follow-up Study

AIM: To report real-life data of eyes with neovascular age-related macular degeneration (nAMD) treated with vascular endothelial growth factor (VEGF) inhibitors for an average of 10 years. METHODS: Anti-VEGF naïve eyes with nAMD and had at least 7-year follow-up at a tertiary center were evaluated. The primary outcome was a change in best-corrected visual acuity (BCVA) at 10 years; secondary outcomes included anatomical outcomes, number of injections, and examinations. RESULTS: The study included 102 eyes of 82 patients, with a mean initial age of 69.2 ± 9.7 years. The average follow-up duration was 116.19 ± 24.98 months, and the mean number of injections was 37.42 ± 15.81. Initial mean BCVA was 59.0 ± 18.3 letters, increasing to 70.55 ± 12.72 in the first year, then gradually declining to 60.44 ± 17.55 by the tenth year. Patients had an average of 6.13 ± 1.72 exams in the first year and 4.61 ± 2.60 in the last year, with 6.02 ± 1.70 injections in the first year and 3.18 ± 2.17 in the tenth year. Patients were classified as increasing, decreasing, or stable based on changes in VA by 2 lines or 10 letters. Significant variables among the groups included age (p=0.018), baseline BCVA (p=0.001), prior photodynamic therapy (PDT) (p=0.025), and retinal hemorrhage due to macular neovascularization (MNV) (p=0.049). CONCLUSION: Eyes with nAMD maintained their initial BCVA after treatment with VEGF inhibitors for 10 years. With regular and prompt treatment, functional vision can be achieved over a long period of time in nAMD.