Macular neovascularization lesion type and vision outcomes in neovascular age-related macular degeneration: post hoc analysis of HARBOR

• DOI: 10.1007/s00417-022-05586-w
• Publication Date: 2022-03-03T07:02:42Z
• Authors: K. Bailey Freund; Giovanni Staurenghi; Jesse J. Jung; Sandrine A. Zweifel; Mariano Cozzi; Lauren Hill; Steven Blotner; Min Tsuboi; Shamika Gune
• Keywords: Visual Acuity; Angiogenesis Inhibitors; Choroidal Neovascularization; Macular Degeneration; 03 medical and health sciences; Treatment Outcome; 0302 clinical medicine; Ranibizumab; Intravitreal Injections; Wet Macular Degeneration; Retinal Disorders; Humans; Consensus on Neovascular Age-Related Macular Degeneration Nomenclature (CONAN); Macular neovascularization; Neovascular age-related macular degeneration; Ranibizumab; Visual acuity;; Tomography, Optical Coherence

To characterize relationships between Consensus on Neovascular Age-Related Macular Degeneration Nomenclature (CONAN) Study Group classifications of macular neovascularization (MNV) and visual responses to ranibizumab in patients with neovascular age-related macular degeneration (nAMD).This was a post hoc analysis of the phase 3 HARBOR trial of ranibizumab in nAMD. Analyses included ranibizumab-treated eyes with baseline multimodal imaging data; baseline MNV; subretinal and/or intraretinal fluid at screening, baseline, or week 1; and spectral-domain optical coherence tomography images through month 24 (n = 700). Mean best-corrected visual acuity (BCVA) over time and mean BCVA change at months 12 and 24 were compared between eyes with type 1, type 2/mixed type 1 and 2 (type 2/M), and any type 3 MNV at baseline.At baseline, 263 (37.6%), 287 (41.0%), and 150 (21.4%) eyes had type 1, type 2/M, and any type 3 lesions, respectively. Type 1 eyes had the best mean BCVA at baseline (59.0 [95% CI: 57.7-60.3] letters) and month 24 (67.7 [65.8-69.6] letters), whereas type 2/M eyes had the worst (50.0 [48.6-51.4] letters and 60.8 [58.7-62.9] letters, respectively). Mean BCVA gains at month 24 were most pronounced for type 2/M eyes (10.8 [8.9-12.7] letters) and similar for type 1 (8.7 [6.9-10.5] letters) and any type 3 eyes (8.3 [6.3-10.3] letters).Differences in BCVA outcomes between CONAN lesion type subgroups support the use of an anatomic classification system to characterize MNV and prognosticate visual responses to anti-vascular endothelial growth factor therapy for nAMD.ClinicalTrials.gov identifier: NCT00891735. Date of registration: April 29, 2009.