Three-year outcomes of treatment of wet age-related macular degeneration in the Polish therapeutic program

Introduction
Three-year evaluation of outcomes of wet age-related macular degeneration treatment with intravitreal injections of aflibercept and ranibizumab in routine clinical practice within the framework of the Polish National Health Fund therapeutic program.

Material and methods
A total of 135 patients (135 eyes), with a median age of 82.0 [74.0, 86.5] years were enrolled in a non-randomized, retrospective, observational, single-center study. A total of 78 (57.8%) eyes were treatment-naive. Treatment was provided in accordance with the guidelines set out in the therapeutic program, based on a fixed or pro re nata regimen.

Results
After the first year of treatment, there was a mean gain of 4.86 [12.50], after the second year 4.72 [12.67] (p> 0.05), and after the third year a significantly lower gain of 3.26 [12.21] ETDRS letters. A significant reduction in central retinal thickness was observed. In the first year, 8.00 [6.00, 8.00] injections were performed. In the following years, the number was significantly smaller (5.00 [4.00, 6.00]). In the treatment-naive subgroup, the best corrected visual acuity improved significantly during the first and second years of treatment, and was significantly higher compared to the pretreated subgroup.

Conclusions
Regular treatment of wet age-related macular degeneration in line with the guidelines set out in the therapeutic program leads to functional stabilization and significant morphological improvement over a long-term follow-up (3 years), with significantly fewer injections administered after the first year of treatment. During the initial two years of the therapeutic program, treatment-naive eyes exhibited significantly higher functional parameters compared to pretreated eyes.