Eyeworld

EW RETINA 84 February 2015 by Tony Realini, MD, MPH, EyeWorld Contributing Writer Anti-VEGF therapy from the patient's perspective A nti-VEGF (vascular en- dothelial growth factor) therapy has been as close to a magic bullet as we have seen in therapeutic ophthalmology. No longer does the diagnosis of neovascular age-relat- ed macular degeneration (AMD) mean near-certain vision loss—the majority of treated patients preserve stable visual acuity, and significant proportions gain substantial acu- ity with treatment. Bevacizumab (Avastin, Genentech, South San Francisco), ranibizumab (Lucentis, Genentech), and aflibercept (Eylea, Regeneron Pharmaceuticals, Tarry- town, N.Y.) therapy's impact extends well beyond AMD as well—this near-panacea is effective in treating macular edema due to diabetes and retinal vein occlusion, can regress anterior segment neovascularization, and may help modulate wound healing in glaucoma surgery, among its many applications. The game-changing impact of anti-VEGF therapy is evident to all ophthalmologists, who appreciate the natural history of diseases such as AMD and see firsthand every day what a difference these drugs make in patients' lives. But physicians' perceptions are based on having treated large numbers of patients— The study described [here] as well as others in the literature confirm that patients treated with anti-VEGF therapy can appreciate the measured gains in acuity, with positive effects on their quality of life. dozens or even hundreds—and seeing the overall effect. What about the patient's per- spective? Are patients as impressed with anti-VEGF therapy as physi- cians? After all, the needle goes into their eye. And can patients fully appreciate the benefit of therapy —can someone who has not lost vision fully appreciate not having lost vision? Quality of life "Anti-VEGF therapies have been shown to significantly improve quality of life in patients with neovascular AMD," reported Wijeyanthy Wijeyakumar, MOTH, a PhD candidate from Sydney, Australia, in a poster presentation at the 2014 Association for Research in Vision and Ophthalmology meeting. To contribute to the body of research on this topic, Andrew Chang, MBBS, PhD, FRANZCO, FRACS, and his team, including Ms. Wijeyakumar, conducted a prospective analysis in which 49 patients who were resis- tant to other anti-VEGF therapies were treated with the newest agent, aflibercept. Patients were treated with 3 loading doses of intravitre- al aflibercept every 4 weeks apart followed by injections every 8 weeks over 48 weeks. Best corrected visual Under the aegis of Russian ophthalmologists Society

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