Wet AMD Patients Stand to Lose One Line of Vision from Lapse in Therapy, Study Says

With a significant number of neovascular age-related macular degeneration (nAMD) patients requiring repeated intravitreal injections and close monitoring to maintain vision, patient adherence to therapy regimens remains a significant challenge. In a retrospective multicenter study, researchers used data from the Fight Retinal Blindness! (FRB!) registry to evaluate visual outcomes and visit gap occurrences in patients receiving anti-VEGF therapy. They found that visit gaps are common and lead to significant, often irreversible, functional decline, particularly in eyes with active choroidal neovascularization (CNV) and no subfoveal macular atrophy (MA). The findings were reported in Ophthalmology Retina. Visit gaps in wet AMD patients are common and lead to significant functional decline, particularly in eyes with active CNV and no subfoveal MA. Findings from this study highlight the necessity of continuous monitoring and adherence-focused care strategies to improve long-term outcomes. Photo: Goncalves L, et al. Ophthalmology Retina. April 14, 2026. Click image to enlarge. The researchers analyzed data on 262 treatment-naïve nAMD eyes that began intravitreal anti-VEGF, had more than one injection and then experienced a visit gap of six to 12 months, with subsequent follow-up over the next nine months (≥3 visits). Treated eyes experiencing a six to 12-month visit gap had a significant drop in vision, with a mean estimated change in VA of -4.9 letters following the gap. Further analysis confirmed a significant decline in the estimated mean change in VA of approximately one line immediately after the six to 12-month visit gap, which remained relatively stable and unrecovered. “This suggests that the effect of treatment interruption on vision is concentrated at the time of the gap rather than evolving progressively thereafter,” the authors wrote in their paper.Eyes with active CNV at the visit preceding the gap experienced a greater mean VA loss than those with inactive lesions. While vision remained stable in eyes with inactive CNV after the gap, it showed potential for recovery in eyes with active CNV once treatment resumed. “This suggests that disease activity dynamics across the interruption are important in interpreting functional outcomes after prolonged lapses in follow-up,” the authors wrote in their paper. “This finding is not surprising and confirms the detrimental visual effects of ongoing fluid when care is interrupted in nAMD.”Eyes without subfoveal MA experienced a significant loss of vision, while those with pre-existing subfoveal MA showed stable vision, potentially due to a so-called floor effect. “The result suggests that pre-existing atrophic damage to the fovea may limit the potential for further visual decline, possibly due to a floor effect where central vision is already impaired,” the authors wrote. Wet AMD eyes with a longer time interval since last injection were more likely to experience a visit gap, while eyes with better VA and that had active CNV with subretinal fluid only at follow-up visits were less likely.Visit gaps are common in routine practice; approximately a quarter of eyes experienced a six to 12-month gap within 6.5 years, the researchers noted. Longer injection intervals and longer times since the last injection were associated with an increased likelihood of visit gaps, while better baseline VA, receiving an injection at each follow-up visit and the presence of subretinal fluid only were associated with a lower likelihood of a visit gap.Click here for the journal source. Goncalves L, Hashimoto Y, Barthelmes D, et al. Real-world outcomes in neovascular AMD with visit gaps under anti-VEGF therapy: data from the FRBI registry. Ophthalmology Retina. April 14, 2026. [Epub ahead of print.]  This article was developed by the editorial staff in conjunction with experts in the field. In the process, AI may have been among the editorial tools used to meet the goals of human editors, who approved all content.