Driving vision in patients with neovascular AMD in anti-VEGF treatment

Author: Yousif Subhi (Denmark)

Co-authors: Nanna Jo Ferløv Baselius, Troels Brynskov, Mads Krüger Falk, Torben Lykke Sørensen

Purpose

To report real‐world experiences on driving vision in patients with neovascular age‐related macular degeneration (AMD) undergoing intravitreal anti‐VEGF treatment.

Setting/Venue

Clinic-based retrospective cohort study of treatment‐naïve patients with neovascular AMD commenced in anti‐VEGF treatment (n = 416).

Methods

Monocular best‐corrected visual acuity (BCVA) was measured using ETDRS on the treatment eye at all visits and on the fellow eye at baseline, every 6 months, and upon any patient‐reported self-perceived change in vision. Driving vision was defined as BCVA in the best‐seeing eye of ≥70 ETDRS letters (equivalent to ≥0.5 Snellen) corresponding to the minimum BCVA required in many countries. Patients were followed for 4 years in a pro re nata treatment regimen.

Results

Driving vision was present in 280 patients (67%) and was sustained in 86%, 74%, 65% and 59% of the patients at 1, 2, 3 and 4 years, respectively. In a multivariate model, lower BCVA in the best‐seeing eye was the only significant predictor of loss of driving vision (HR: 0.90, 95%CI: 0.86 to 0.94, P<0.001). In patients without driving vision at baseline, driving vision was regained in 29%, 36%, 39% and 41% of the patients at 1, 2, 3 and 4 years, respectively; but only 35% sustained driving vision after the first year. In a multivariate model, lower age (HR: 0.91, 95%CI: 0.86 to 0.95, P<0.001) and higher BCVA in best‐seeing eye (HR: 1.09, 95%CI: 1.05 to 1.12, P<0.001) were the only significant predictors of regain of driving vision.

Conlusions

Driving vision can be sustained in the majority of the patients if they have driving vision at baseline and follow the recommended anti-VEGF treatment. This study provides important prognostic information for patients with neovascular AMD.

Financial Disclosure

None.