Effect of pseudoexfoliation on anti-vascular endothelial growth factor treatment of neovascular age-related macular degeneration

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Atalay K., KALDIRIM H., Savur F., Erdogan M. G.

Tropical Journal of Pharmaceutical Research, cilt.24, sa.7, ss.889-894, 2025 (Scopus)

Özet

Purpose: To evaluate short-term outcomes of anti-vascular endothelial growth factor (anti-VEGF) treatment in patients with neovascular age-related macular degeneration (nAMD), with and without Pseudoexfoliation syndrome (PEX). Methods: This retrospective study was carried out at Istanbul Bagcilar Training and Research Hospital, Istanbul, Turkey. Demographic and clinical examination data were collected from charts of patients treated between May 2014 and May 2019, and the cohort comprised 44 eyes from 43 patients. PEX group had 22 eyes from 17 patients diagnosed with both PEX and nAMD, while control group comprised 22 eyes from 21 patients diagnosed with nAMD only. Both groups were treatment-naïve patients who visited the clinic for the first time and all patients received at least three-monthly intravitreal injections of 1.25 mg/0.05 mL bevacizumab, 0.5 mg/0.1 mL ranibizumab, or 2 mg/0.05 mL aflibercept. The treatment response was evaluated at the 3-month follow-up using optical coherence tomography (OCT) and best corrected visual acuity (BCVA). Results: Results show that BCVA was significantly improved from baseline in PEX group (p = 0.002) and control group (p = 0.005). Systemic hypertension and retinal pigment epithelium detachment were more common in PEX group than in control group (p = 0.031 and p = 0.035, respectively). Lesion thickness on OCT decreased from 594.31 ± 218.04 µm to 427.63 ± 118.43 µm in PEX group (p < 0.001) and from 570.72 ± 202.58 µm to 417.90 ± 153.07 µm in control group (p = 0.003). Although the central macular thickness decreased in PEX group, the difference was not significant (p = 0.064). Conclusion: Anti-VEGF treatment is an effective option in nAMD patients with PEX. Prospective, randomized studies may clarify the interactions between PEX, nAMD and anti-VEGF treatment.