Adherence to Anti-VEGF Treatment in Patients with Neovascular Age-Related Macular Degeneration: A Real-World Study

Introduction: The evolution of treatment patterns in neovascular age-related macular degeneration (nAMD) warrants investigation into the impact of patients’ adherence to anti-vascular endothelial growth factor (VEGF) treatment on visual outcomes. This retrospective, non-randomized, non-comparative study aimed to investigate real-world adherence to anti-VEGF treatment.

Methods: Patient (eyes) (≥ 50 years) with a diagnosis of nAMD who had a first injection of aflibercept or ranibizumab between January 2016 and December 2018 and 12 months of follow-up were included. Visual acuity (VA; logMAR letters) and duration of injection intervals were recorded. Adherence was defined as < 20% of visits deviating from the schedule by ≥ 14 days. Results: Overall, 133 patient eyes were included: 129 adherent, and four non-adherent. Mean (standard deviation) baseline VA was 57.0 (23.6) and 53.8 (35.3) letters in adherent and non-adherent patient eyes, respectively. Mean change in VA by month 12 was higher in adherent (6.3 letters) than non-adherent patient eyes (- 11 letters). Compared with the previous visit, adherent visits were associated with a mean increase in VA of 0.67 letters and non-adherent visits with a decrease of 2.30 letters. Conclusions: These results emphasize the importance of adherence to appropriate dosing regimens to optimize visual outcomes in patients with nAMD. Keywords: Adherence; Aflibercept; Age-related macular degeneration (AMD); Anti-VEGF; Disease activity; Ranibizumab; Visual acuity. © 2025. The Author(s).