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    Do more anti-VEGF injections lead to better clinical outcomes?


    Results from the LUMINOUS Study showed the other end of the treatment spectrum.

    After a mean of 4.3 to 5.7 injections over 12 months, visual acuity had largely returned to baseline for about 3,500 patients in Germany, the Netherlands, Belgium, and Sweden.

    “The one positive thing I can say about those who continue to give a relatively low number of treatments on average is that even if patients do not have much improvement in visual acuity, they will have avoided the natural history of losing 24 letters over two years,” Dr. Larsen explained.

    “We have to remember that many young ophthalmologists have never seen the spontaneous course of wet AMD.”

    “For patients who start out at 20/20 visual acuity, after the first year of wet AMD, they will have lost their driver’s license. After the second year, they will have lost the ability to read without telescopic lenses or devices such as an iPad,” he added. “Even inadequate treatment can slow the decline in visual loss, even if patients do not get much of a gain in visual acuity.”

    Retrospective studies also show that as many as 1/3 of patients may lose 15 letters or more due to geographic atrophy and fibrosis.

    The loss is more severe in cases with classic lesion components and under-treatment.

    Frequent treatment definitely cannot prevent the loss of 15 or more letters, but continuing loss of acuity is much less likely for patients who receive an adequate number of injections.

    Frequent office visits

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