Patients with age-related macular degeneration (AMD) may suffer a decline in visual acuity if they stop treatment for long summer holidays, according to researchers from France, Canada and Switzerland.
‘It is important to convey the message of treatment adherence to patients, despite their need of holidays,’ the researchers wrote in a recent article for the journal Eye.
Visual acuity in patients who stopped treatment during vacation declined by 0.071 Logarithm of the Minimum Angle of Resolution (LogMAR), compared to a 0.003 improvement in patients who continued their treatments. The difference was statistically significant (P = 0.007)
France has a particularly strong tradition of long summer vacations, the researchers noted, dating back nine centuries to a decree by Pope Gregory II in 1231. So researchers at Cergy Pontoise Hospital in Paris, France, compared 23 patients who missed one injection during their summer holiday to 29 who received injections in this time.
All the patients were getting 0.05 mg ranibizumab intravitreal injections pro re nata (PRN) at Cergy Pontoise. The treatment followed a protocol of three initial monthly injections followed by reinjection as needed.
Criteria for reinjection included a visual acuity loss of 45 ETDRS letters and/or an increase of central retinal thickness, presence of subretinal fluid, intraretinal fluid, or pigment epithelium detachment. If reinjection criteria were not met, patients were advised to return in 4 weeks.
In order to be included, patients had to be at least 50 years old, have a presence of subfoveal choroidal neovascularisation (CNV) secondary to AMD as evaluated by fundus biomicroscopy, fluorescein angiography (FA) and infracyanine green angiography (ICGA), and a presence of serous retinal detachment or pigment epithelium detachment detected on spectral domain-optical coherence tomography (SD-OCT).
All eyes included in this study showed evidence of exudation on OCT (subretinal or intraretinal fluid) during the visit preceding vacation.