Visual Acuity and Intraretinal Fluid as Predictive Factors for Legal Blindness and Macular Atrophy in Neovascular AMD Eyes Treated with Anti-VEGF : A Swedish Real-World Study
(2026) In Clinical Ophthalmology 20.- Abstract
Purpose: Ocular coherence tomography (OCT) biomarkers have previously been able to predict low visual acuity (VA). The purpose of this study was to identify other OCT predictors for a final VA ≤35 and risk factors for macular atrophy (MA) in eyes with neovascular age-related macular degeneration (nAMD). Methods: This retrospective observational study included 107 treatment naïve nAMD eyes who initiated treatment and were followed for 3 years ± 2 months or until VA deterioration to or below 35 ETDRS letters. Eyes with final VA ≤35 letters (low VA group) were compared with those with a final VA >35 letters (maintenance group). Swedish Macula Register (SMR) data and OCT images were analyzed to identify risk factors for MA development... (More)
Purpose: Ocular coherence tomography (OCT) biomarkers have previously been able to predict low visual acuity (VA). The purpose of this study was to identify other OCT predictors for a final VA ≤35 and risk factors for macular atrophy (MA) in eyes with neovascular age-related macular degeneration (nAMD). Methods: This retrospective observational study included 107 treatment naïve nAMD eyes who initiated treatment and were followed for 3 years ± 2 months or until VA deterioration to or below 35 ETDRS letters. Eyes with final VA ≤35 letters (low VA group) were compared with those with a final VA >35 letters (maintenance group). Swedish Macula Register (SMR) data and OCT images were analyzed to identify risk factors for MA development and low VA. MA was defined according to the criteria for Complete Retinal Pigment Epithelium and Outer Retinal Atrophy (cRORA), which was based on OCT parameters. Results: Twenty eyes (19%) were presented with a final VA ≤35 ETDRS letters. Mean time from baseline to ≤35 ETDRS letters was 587.7 ± 330.4 days, with a mean 9.7 ± 5.3 injections during that period. Mean baseline VA in the maintenance group vs the low VA group were 65.4 ± 10.8 and 52.0 ± 10.6, respectively; p <0.001. Lower baseline VA was a predictor for low final VA. At baseline, 87% did not have MA on OCT. Among eyes with at least 1 OCT follow-up value in this group, 25% developed MA during the 3-year period. The presence of intraretinal fluid (IRF) at baseline was a predictor for MA development within 3 years in this subgroup. Conclusion: After 3 years, 19% had declined to VA ≤35 ETDRS letters. About 25% with ≥1 available OCT follow-ups developed MA. Lower baseline VA predicted a final VA ≤35 ETDRS letters in nAMD eyes. IRF at baseline predicted MA. The high prevalence of missing VA values emphasizes the importance of increasing the frequency of VA testing.
(Less)
- author
- Wickman, Isac LU ; Huzevkova, Ivana ; Schroeder, Marion LU ; Granstam, Elisabet ; Kjellström, Ulrika LU and Lövestam-Adrian, Monica LU
- organization
- publishing date
- 2026
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- anti-VEGF, macular atrophy, Swedish macula register
- in
- Clinical Ophthalmology
- volume
- 20
- article number
- 579968
- publisher
- Dove Medical Press Ltd.
- external identifiers
-
- scopus:105037548613
- pmid:42088264
- ISSN
- 1177-5467
- DOI
- 10.2147/OPTH.S579968
- language
- English
- LU publication?
- yes
- id
- 5449994d-027e-47c2-a842-221f03622a66
- date added to LUP
- 2026-07-07 11:08:29
- date last changed
- 2026-09-01 16:03:31
@article{5449994d-027e-47c2-a842-221f03622a66,
abstract = {{<p>Purpose: Ocular coherence tomography (OCT) biomarkers have previously been able to predict low visual acuity (VA). The purpose of this study was to identify other OCT predictors for a final VA ≤35 and risk factors for macular atrophy (MA) in eyes with neovascular age-related macular degeneration (nAMD). Methods: This retrospective observational study included 107 treatment naïve nAMD eyes who initiated treatment and were followed for 3 years ± 2 months or until VA deterioration to or below 35 ETDRS letters. Eyes with final VA ≤35 letters (low VA group) were compared with those with a final VA >35 letters (maintenance group). Swedish Macula Register (SMR) data and OCT images were analyzed to identify risk factors for MA development and low VA. MA was defined according to the criteria for Complete Retinal Pigment Epithelium and Outer Retinal Atrophy (cRORA), which was based on OCT parameters. Results: Twenty eyes (19%) were presented with a final VA ≤35 ETDRS letters. Mean time from baseline to ≤35 ETDRS letters was 587.7 ± 330.4 days, with a mean 9.7 ± 5.3 injections during that period. Mean baseline VA in the maintenance group vs the low VA group were 65.4 ± 10.8 and 52.0 ± 10.6, respectively; p <0.001. Lower baseline VA was a predictor for low final VA. At baseline, 87% did not have MA on OCT. Among eyes with at least 1 OCT follow-up value in this group, 25% developed MA during the 3-year period. The presence of intraretinal fluid (IRF) at baseline was a predictor for MA development within 3 years in this subgroup. Conclusion: After 3 years, 19% had declined to VA ≤35 ETDRS letters. About 25% with ≥1 available OCT follow-ups developed MA. Lower baseline VA predicted a final VA ≤35 ETDRS letters in nAMD eyes. IRF at baseline predicted MA. The high prevalence of missing VA values emphasizes the importance of increasing the frequency of VA testing.</p>}},
author = {{Wickman, Isac and Huzevkova, Ivana and Schroeder, Marion and Granstam, Elisabet and Kjellström, Ulrika and Lövestam-Adrian, Monica}},
issn = {{1177-5467}},
keywords = {{anti-VEGF; macular atrophy; Swedish macula register}},
language = {{eng}},
publisher = {{Dove Medical Press Ltd.}},
series = {{Clinical Ophthalmology}},
title = {{Visual Acuity and Intraretinal Fluid as Predictive Factors for Legal Blindness and Macular Atrophy in Neovascular AMD Eyes Treated with Anti-VEGF : A Swedish Real-World Study}},
url = {{http://dx.doi.org/10.2147/OPTH.S579968}},
doi = {{10.2147/OPTH.S579968}},
volume = {{20}},
year = {{2026}},
}