Effects of treatment change in patients with neovascular age-related macular degeneration; results from the Czech National Registry.

Aims. To determine the effectiveness of second line treatments in patients with neovascular AMD who did not respond adequately to primary treatment. Methods. Retrospective, multicentre assessment. The frequency of primary treatment failure and outcomes of subsequent secondary treatment were assessed according to the type of primary treatment, type of CNV and change in BCVA over a 12 month period. Results. At the time of assessment 750 entries (750 treated eyes, 725 treated patients) had follow-up longer than 12 months. A treatment change required 7.7% subjects treated with ranibizumab, 20.5% with pegaptanib and 22% with PDT and verteporfin. Average BCVA of all patients at the beginning of primary treatment was 50.7 +/- 3 letters and 43 +/- 3.5 letters in 12th month (P<0.001). The mean decrease in BCVA was 7.7 +/- 0.6 letters during the first 6 months of observation. During the next 6 months, no significant change occurred. The change of primary therapy was required on average after 6.5 +/- 2.1 months. Conclusion. BCVA loss was the most significantly decelerated in patients who received ranibizumab as a secondary therapy following unsuccessful treatment with pegaptanib sodium.