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Taiwan J Ophthalmol. 2019 Dec 13;9(4):249-254. doi: 10.4103/tjo.tjo_34_19. eCollection 2019 Oct-Dec.

Real-world outcomes of intravitreal antivascular endothelial growth factors for neovascular age-related macular degeneration in Taiwan: A 4-year longitudinal study.

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College of Medicine, National Taiwan Universtiy, Taipei, Taiwan.
College of Medicine, University of Queensland, Brisbane, Australia.
Department of Ophthalmology, Changhua Christian Hospital, Changhua, Taichung, Taiwan.
College of Medicine, Chung-Shan Medical University, Taichung, Taiwan.



The purpose of the study is to report the long-term efficacy of patients with neovascular age-related macular degeneration (nAMD) treated with antivascular endothelial growth factor (VEGF) in Changhua Christian Hospital in Taiwan.


Retrospective case series of patients with nAMD who were treated with intravitreal injection (IVI) of anti-VEGF and had a minimum follow-up of 48 months. Every patient was initially treated with three loading doses of either bevacizumab or ranibizumab, followed by a loose treat and extend regimen. Eyes were divided into two groups according to whether aflibercept was later used as a rescue therapy (Group 2) or not (Group 1). Patients underwent best-corrected visual acuity (BCVA) testing, optical coherence tomography, and ophthalmic examination at baseline and all the scheduled follow-up visits.


Seventy eyes in 63 patients were included (mean age 70.54 ± 9.18 years). The mean number of IVIs per year was 5.28 ± 1.36. The mean BCVA in logarithm of the minimal angle of resolution (logMar) improved from 0.89 ± 0.45 to 0.72 ± 0.49 for all patients (P = 0.004). Significant visual improvement was noted in Group 1 (P = 0.01) at 4 years of follow-up, but not in Group 2 (P = 0.16). Patients with initial poor BCVA (LogMar visual acuity >1.0), and older age (>70 years) had significant visual improvement, in contrast to no significant visual changes in patients with younger age and initial better BCVA.


Under a loose treat and extend protocol and rescue therapy of aflibercept, BCVA improvement was maintained for 4 years in patients with nAMD, especially in the older population (Registration Number: NCT03324542).


Aflibercept; age-related macular degeneration; bevacizumab; long term efficacy; ranibizumab

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