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KMID : 1151620190040010010
Journal of Retina
2019 Volume.4 No. 1 p.10 ~ p.16
Clinical Course of Patients with Neovascular Age-related Macular Degeneration Who Experienced Visual Deterioration after Treatment despite Initially Good Visual Acuity
Shin Kyung-Hoon

Kim Jong-Woo
Kim Chul-Gu
Lee Dong-Won
Kim Jae-Hui
Abstract
Purpose: To evaluate the clinical course of patients with neovascular age-related macular degeneration (AMD) who experienced severe visual deterioration despite initially good visual acuity.

Methods: This retrospective observational study included patients diagnosed with wet AMD and treated with anti-vascular endothelial growth factor. Only patients whose initial best-corrected visual acuity (BCVA) was 0.5 or better but deteriorated to 0.1 or worse at the final visit were included. Patients were classified into three groups and analyzed; patients who experienced development of submacular hemorrhage (SMH) during the follow-up period were classified as SMH, patients who were lost to follow-up but then revisited were classified as lost to follow-up, and remaining patients were classified as remaining.

Results: Fifty-five eyes of 55 patients were included in the study. The mean follow-up period was 43.5 ¡¾ 9.4 months. In the SMH group (n = 28), the mean logarithm of minimal angle of resolution (logMAR) BCVA was 0.46 ¡¾ 0.25 before SMH, 1.10 ¡¾ 0.30 at SMH onset, and 1.37 ¡¾ 0.46 at final follow-up. In the lost to follow-up group (n = 14), the mean BCVA was 0.33 ¡¾ 0.16 before follow-up loss, 1.33 ¡¾ 0.36 at the revisit, and 1.36 ¡¾ 0.46 at final follow-up. In the remaining group, mean BCVA was 0.24 ¡¾ 0.09 at diagnosis and 1.40 ¡¾ 0.37 at final follow-up.

Conclusions: Marked visual deterioration after SMH and loss to follow-up may be causes of severe visual loss in patients with neovascular AMD who initially showed good visual acuity.
KEYWORD
Age-related macular degeneration, Choroidal neovascularization, Treatment outcome
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