Long-Term Outcomes of Anti-VEGF Therapy in Neovascular Age-Related Macular Degeneration: A Systematic Review | ||||
| The Egyptian Journal of Hospital Medicine | ||||
| Article 11, Volume 98, Issue 1, January 2025, Page 73-79 PDF (394.09 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ejhm.2025.401101 | ||||
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| Abstract | ||||
| Objectives: To systematically assess the long-term outcomes of anti-vascular endothelial growth factors (anti-VEGF) therapy in patients with neovascular age-related macular degeneration (nAMD). Methods: A thorough search across four databases identified 563 relevant publications. After removing duplicates using Rayyan QCRI and screening for relevance, 322 full-text articles were reviewed, with 7 studies ultimately meeting the criteria for inclusion. Results: We included seven studies with a total of 2013 nAMD patients and less than half of them were males 850 (42.2%). Long-term anti-VEGF therapy in nAMD demonstrates sustained efficacy, though several key outcomes have emerged. First, retinal perfusion changes were inconsistent, with no clear correlation between injection frequency and peripapillary perfusion. Despite long-term therapy, some patients experienced persistent macular neovascularization. Additionally, the gradual development of retinal atrophy was a common outcome after 3-5 years, contributing to a modest decline in visual function over time. Retinal vascular density, particularly in the superficial plexus, also decreased with prolonged treatment. Overall, while anti-VEGF therapy is well-tolerated and effective initially, these long-term structural changes may limit its sustained visual benefits. Conclusion: Anti-VEGF therapy has significantly improved the prognosis for patients with nAMD, offering stabilization or improvement in vision and reducing the risk of severe visual loss. However, long-term outcomes highlight important challenges, such as the gradual development of retinal atrophy and the persistence of macular neovascularization (MNV) in some patients. | ||||
| Keywords | ||||
| Neovascular age-related macular degeneration; Anti-VEGF therapy; Long-term outcomes; Systematic review | ||||
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