ArticleClinical ophthalmology (Auckland, N.Z.)2026
Real World Data About the Treatment of Wet Age-Related Macular Degeneration in Kuopio University Hospital During 2019-2021 Using a PRN Regimen.
Article in Clinical ophthalmology (Auckland, N.Z.), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Purpose: To evaluate the real-world effectiveness of a pro re nata (PRN) anti-vascular endothelial growth factor (anti-VEGF) regimen for neovascular age-related macular degeneration (nAMD) during 2019-2021 at Kuopio University Hospital, including the COVID-19 pandemic period. Methods: This retrospective study included 107 patients (162 eyes) treated with intravitreal anti-VEGF injections for nAMD. The included eyes were not treatment-naive at study entry but had received anti-VEGF treatment before 2019. Annual injection numbers, drug choice (bevacizumab or aflibercept 2 mg), central retinal thickness (CRT), and visual acuity (VA) were analyzed from diagnosis through 2021 using independent-sample t-tests. Results: The mean number of injections in the first treatment year was 6.79 ± 2.32. During 2019-2021, annual means were 5.09 ± 2.33, 5.40 ± 2.10, and 4.96 ± 2.11, respectively. Bevacizumab-treated eyes received significantly more injections than aflibercept-treated eyes across all years (p < 0.01 for 2019; p < 0.05 for 2020-2021). Mean VA declined from 70 ± 57 ETDRS letters at diagnosis to 62 ± 57 ETDRS letters by late 2021 (p < 0.0001). In the aflibercept-only subgroup, the decline was smaller and not significant (68 ETDRS letters ± 55 ETDRS letters to 66 ± 56 ETDRS letters; p > 0.27). CRT decreased significantly from 388.4 ± 139.4 µm at diagnosis to 320.8 ± 114.7 µm in 2019 and remained stable thereafter (p < 0.0001 vs. baseline; p > 0.5 between years). Conclusion: The PRN regimen maintained anatomical outcomes but resulted in gradual visual decline, likely due to fewer injections, particularly during the COVID-19 period. Aflibercept required fewer injections without compromising outcomes. Transitioning toward a treat-and-extend protocol may enhance visual stability and cost-effectiveness in nAMD care.
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