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BioMed Research International
Volume 2018 (2018), Article ID 9640131, 10 pages
https://doi.org/10.1155/2018/9640131
Review Article

Baseline Predictors of Visual Acuity Outcome in Patients with Wet Age-Related Macular Degeneration

1Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Tongren Hospital, Capital Medical University, Beijing 100730, China
2Pao So Kok Macular Disease Treatment and Research Centre and Department of Ophthalmology & Visual Sciences, No. 4/F, Hong Kong Eye Hospital, The Chinese University of Hong Kong, 147K Argyle Street, Kowloon, Hong Kong
32010 Retina and Macula Centre, Kowloon, Hong Kong

Correspondence should be addressed to Xinyuan Zhang; moc.361@0102yxzmm

Received 2 September 2017; Revised 1 January 2018; Accepted 18 January 2018; Published 26 February 2018

Academic Editor: Mitsuru Nakazawa

Copyright © 2018 Xinyuan Zhang and Timothy Y. Y. Lai. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Age-related macular degeneration (AMD) is one of the leading causes of severe vision loss in people over 60 years. Wet AMD (wAMD) causes more severe visual acuity (VA) loss compared with the dry form due to formation of choroidal neovascularization (CNV). Antivascular endothelial growth factor (anti-VEGF) agents such as ranibizumab and aflibercept are now the standard of care treatment for wAMD. Unfortunately, up to a quarter of anti-VEGF-treated wAMD patients might not fully benefit from intravitreal injections and CNV activity may not respond to the treatment and these patients are called anti-VEGF nonresponders. This article aims to discuss the baseline factors associated with VA outcome such as age, initial VA, lesion types, disease duration, optical coherence tomography (OCT) features, fundus autofluorescence findings, and the presence of particular genotype risk alleles in patients with wAMD. Recommendations are provided regarding when to consider discontinuation of therapy because of either success or futility. Understanding the predictive factors associated with VA outcome and treatment frequency response to anti-VEGF therapy may help retina specialists to manage patients’ expectations and guide treatment decisions from the beginning of treatment on the basis of “personalized medicine.”