A recent study has found that associations between morphological changes and visual acuity (VA) persist in age-related macular degeneration (AMD) patients, with significant decline in acuities between two and five years after anti-vascular endothelial growth factor (anti-VEGF) treatment.

Researchers reported the findings from a five-year follow-up of 523 participants from the Comparison of Age-related Macular Degeneration Treatments Trials, which randomly assigned ranibizumab or bevacizumab to eyes with AMD-associated choroidal neovascularization (CNV).

The study identified new foveal scar, CNV, geographic atrophy (GA), intraretinal fluid, subretinal hyper-reflective material and retinal thinning, development or worsening of foveal GA and increased lesion size as important contributors to VA in the period after anti-VEGF therapy.

However, at five years, 38% of eyes had subretinal fluid and 36% had sub-retinal pigment epithelium fluid, both of which are characteristic of GA.

Researchers conclude that there is still a significant need to develop therapies that can address these adverse pathological features and morphological changes in AMD individuals.

Jaffe GJ, Ying GS, Toth CA, et al. Macular morphology and visual acuity in year five of the comparison of AMD treatment trials. Ophthalmology. September 3, 2018. [Epub ahead of print].