Clinical characteristics and intravitreal aflibercept outcomes in patients aged 90 years and older with neovascular age-related macular degeneration

Abstract

Background: Age-related macular degeneration (AMD) stands as the primary cause of visual impairment and blindness among the elderly population. Patients over 90 years comprise a unique demographic that may necessitate particular attention. The aim of this study was to examine the clinical characteristics and treatment outcomes in patients aged 90 years or older diagnosed with neovascular age-related macular degeneration (nAMD). Methods: The medical records of treatment-naive patients aged ≥ 90 years diagnosed with nAMD have been retrospectively reviewed in our clinic. The complete ophthalmic examination findings of the patients, along with optical coherence tomography and fundus fluorescein angiography records, as well as their adherence to treatment, and reasons for treatment discontinuation were noted. Clinical data following intravitreal injection loading dose and during the 1st and 2nd years of treatment were evaluated. Results: The average age of the 45 participants (25 females, 20 males) included in the study was 93.55 ± 5.2 years (range; 90–101). The mean best-corrected visual acuity at diagnosis, at the 4th month of treatment, and during the 1st and 2nd years were LogMAR 0.8, 0.5, 0.7 and 1.0, respectively. The most common reasons for missing appointments and completely discontinuing treatment were death and inability to attend appointments due to additional comorbidities. Conclusion: In the very elderly patient group, nAMD can lead to severe damage in the macula, and a decrease in visual acuity despite treatment is not uncommon. Close monitoring and support for treatment adherence are necessary for this group of patients.