Impact of retinal fluid-free months on outcomes in neovascular age-related macular degeneration: A treatment agnostic analysis of the hawk and harrier studies

David Eichenbaum, David M. Brown, Michael Ip, Arshad M. Khanani, Marta S. Figueroa, Ian L. McAllister, Augustinus Laude, B. Uruprasad, Shuhan Tang, Benjamin Gmeiner, Andreas Clemens, Eric Souied

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Purpose:To assess the effect of the total number of fluid-free months after loading on visual and anatomical outcomes in neovascular age-related macular degeneration patients receiving anti-vascular endothelial growth factor therapy.Methods:This post hoc analysis pooled patient-level data from the brolucizumab 6 mg (n = 718) and aflibercept 2 mg (n = 715) arms of the HAWK and HARRIER randomized clinical trials. Based on data from Weeks 12 to 96, patients were assigned to one of five categories based on fluid-free visits (FFVs; the total number of monthly visits at which they were observed to be without retinal fluid). Three definitions of "fluid-free" were explored based on the location of the fluid observed.Results:Patients allocated to Categories 4 (15-21 FFV) and 5 (22 FFV, always dry) consistently had the best visual and anatomical outcomes at Week 96, whereas patients allocated to Categories 1 (0 FFV, never dry) and 2 (1-7 FFV) consistently had the worst visual and anatomical outcomes. Variability in retinal thickness over time was lowest in Categories 4 and 5.Conclusion:Absence of retinal fluid at more visits after loading has a positive association with visual and anatomic outcomes in neovascular age-related macular degeneration patients, regardless of fluid type.

Original languageEnglish (US)
Pages (from-to)632-640
Number of pages9
JournalRetina
Volume43
Issue number4
DOIs
StatePublished - Apr 1 2023

Keywords

  • aflibercept
  • anti-vascular endothelial growth factor
  • brolucizumab
  • neovascular age-related macular degeneration
  • retinal fluid
  • Receptors, Vascular Endothelial Growth Factor/therapeutic use
  • Hawks
  • Intravitreal Injections
  • Tomography, Optical Coherence
  • Humans
  • Birds
  • Macular Degeneration/drug therapy
  • Wet Macular Degeneration/diagnosis
  • Visual Acuity
  • Animals
  • Recombinant Fusion Proteins/therapeutic use
  • Angiogenesis Inhibitors/therapeutic use

ASJC Scopus subject areas

  • Ophthalmology

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