A study of compliance with antiangiogenic therapy in patients with neovascular age-related macular degeneration

Antiangiogenic therapy of neovascular age-related macular degeneration (nAMD) demonstrates limited patient commitment to this treatment.

Purpose of the study is to evaluate the influence of comorbid, clinical, ophthalmological and demographic factors on compliance with antiangiogenic therapy in patients with nAMD.

Materials and methods. The data of 105 eyes of 98 patients with nAMD who received antiangiogenic therapy from January 1, 2018, to December 31, 2022, with a follow-up period of at least 24 months were retrospectively analyzed; the withdrawal criterion was the termination of treatment and follow-up (absence of visits) by patients for more than 6 months. The influence of clinical, ophthalmological, therapeutic, methodological, and comorbid factors (cataract surgery) was evaluated during the follow-up period.

Results. As part of the study, 29.6 % of patients (29 people) stopped treatment and follow-up. The reasons for withdrawal included: remission of the disease (31.7 % of the discharged patients), development of macular atrophy (26.8%), transfer to another medical facility (12.2 %) and a few others. The average interval before the cease of treatment was 29.45 ± 10.39 months. Dropout from follow-up is more typical for older patients. Patients with bilateral nAMD had a lower loss to follow-up rate (LTFR) (chi-square, p < 0.0001). The type of macular neovascularization did not influence loss to follow-up. Patients who underwent cataract phacoemulsification were significantly more likely to discontinue treatment (chi-square, p = 0.012). Correlation analysis did not establish a relationship with the level of BCVA before and after surgery (p > 0.05).

Conclusion. A noticeable influence of demographic, clinical, and comorbid factors on the compliance of patients with AMD has been shown. Withdrawal from observation is more typical for patients who have completed professional activity. The monolateral nature of the disease and surgical treatment of concomitant cataracts negatively affect treatment adherence.

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