Insights from survival analyses during 12 years of anti-VEGF therapy for neovascular age-related macular degeneration

Importance: While multiple imputation models for missing data and use of mixed effects models generally provide better outcome estimates than using only observed data or last observation carried forward in clinical trials, such approaches usually cannot be applied to visual outcomes from retrospective analyses of clinical practice settings, so-called real-world outcomes.

Objective: To explore potential utility of survival analysis techniques for retrospective clinical practice visual outcomes.

Design: Retrospective cohort study with 12-year observation period.

Setting: A tertiary eye center.

Participants: Of 10,744 eyes with neovascular AMD receiving anti-VEGF therapy between October 2008 and February 2020, 7802 eyes met study criteria (treatment-naïve, first-treated eyes starting anti-VEGF therapy).

Main outcome measures: Kaplan-Meier estimates and Cox proportional hazards modelling were used to consider: VA reaching ETDRS (Early Treatment Diabetic Retinopathy Study) let...