Secondary analysis of a neovascular age-related macular degeneration (nAMD) treatment trial shows visit adherence is critical for visual acuity outcomes.
Assistant Professor Brian VanderBeek, University of Pennsylvania, said the importance of appointment adherence has been established in other diseases. “In patients with HIV, for example, studies have found that showing up to appointments has been linked to lower mortality rates and reduced viral loads. But unlike HIV patients, who can have prescriptions filled over the phone by any physician, anti-VEGF therapy can only be administered by an ophthalmologist, making visit adherence even more critical for those with macular degeneration.”
The findings, published by Jama Ophthalmology, are based on analysis of a randomised two-year trial of 1178 patients who were expected to attend visits every four weeks for pro re nata treatments of bevacizumab versus ranibizumab. Each missed visit was associated with an average visual acuity letter score decline of 0.7. Compared with timely patients, those who averaged between 36 to 60 days and more than 60 days between visits lost 6.1 and 12.5 letters, respectively.
When Penn researchers controlled for number of injections, they found that visit adherence was still associated with visual outcomes, independent of how many treatments someone received.
“It’s important to reframe how we think about this. Let’s worry less about predicting a specific number of injections a patient needs and more about getting them into the doctor’s office,” A/Prof VanderBeek said.