A 5-Year Analysis of Optical Coherence Tomography Biomarkers in The Visual Outcomes of an As-Needed Treatment Algorithm for Neovascular Age-Related Macular Degeneration

Objectives This study aimed to predict the visual course of patients with neovascular age-related macular degeneration by analyzing data from a 5-year observational study and to identify biomarkers that have an impact on visual prognosis. Methods The present study comprised a total of 104 patients who received the PRN treatment regimen between March 2015 and March 2021. Best-corrected visual acuity (BCVA) and optical coherence tomography findings were evaluated. Multinomial logistic regression models were used to determine predictors of BCVA at 12, 24, and 60 months. Results Better BCVA and thicker macula at baseline, decreased BCVA at month 3, and persistence of IRF at month 3 were correlated with decreased BCVA at month 12 (all p<0.05). At 24 month, a decline in BCVA was associated with specific baseline characteristics, including better BCVA, absence of pigment epithelial detachment (PED), and presence of intraretinal cystoid fluid (IRF) (all p<0.01). Similarly, decreased BCVA and thicker macula in the 3rd month were associated with worse BCVA. At the 60-month visit, better baseline BCVA, absence of PED, presence of IRF at baseline, and persistence of IRF at month 3 were associated with a reduction in BCVA (all p<0.05). The visual prognosis had no correlation with the number of injections. Conclusion This 5-year real-life study identified prognostic markers that cause a decline in visual acuity. The use of these markers has the potential to be valuable in preserving visual gain, irrespective of the number of injections.