September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Two-year Results of “Treat and Extend” Intravitreal Aflibercept Injection for Exudative Age-related Macular Degeneration
Author Affiliations & Notes
  • Kyo Akika
    Ophthalmology, Osaka City University, Osaka-shi, Osaka, Japan
  • Manabu Yamamoto
    Ophthalmology, Osaka City University, Osaka-shi, Osaka, Japan
  • Ayako Yasui
    Ophthalmology, Osaka City University, Osaka-shi, Osaka, Japan
  • Kumiko Hirayama
    Ophthalmology, Osaka City University, Osaka-shi, Osaka, Japan
  • Takeya Kohno
    Ophthalmology, Osaka City University, Osaka-shi, Osaka, Japan
  • Kunihiko Shiraki
    Ophthalmology, Osaka City University, Osaka-shi, Osaka, Japan
  • Footnotes
    Commercial Relationships   Kyo Akika, None; Manabu Yamamoto, None; Ayako Yasui, None; Kumiko Hirayama, None; Takeya Kohno, None; Kunihiko Shiraki, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 2667. doi:
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    • Get Citation

      Kyo Akika, Manabu Yamamoto, Ayako Yasui, Kumiko Hirayama, Takeya Kohno, Kunihiko Shiraki; Two-year Results of “Treat and Extend” Intravitreal Aflibercept Injection for Exudative Age-related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2016;57(12):2667.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To investigate 2-years results of “treat and extend” (TAE) intravitreal Aflibercept injection (IVA) for exudative age-related macular degeneration (AMD) in Japanese.

Methods : Subjects comprised 76 eyes of 76 patients (50 males and 26 females women) treated with IVA using TAE regimen for treatment-naïve AMD at Department of Ophthalmology, Osaka City University Hospital between February 2013 and September 2013, for whom at least 2 year had elapsed since treatment. Mean age was 74 years old (range 49-92). Best corrected visual acuity (BCVA) examination, fluorescein angiography, indocyanine green angiography and optical coherence tomography (OCT) were performed at baseline. Patients were treated with 3 monthly (4-5 weeks) injection for loading phase, and they were followed by extension of the treatment interval by 2 weeks (up to maximum 13 weeks) provided there were no signs of exudate in OCT. If signs of activity were detected, treatment intervals were shortened to 5 weeks.Patients out of continuing TAE were changed to the Pro Re Nata (PRN) protocol. Patients were classified into 3 groups; eyes treated with TAE for 2 years completely (Group1), eyes treated with TAE for more than 1 year (Group2) and eyes treated with TAE for less than 1 year (Group3) and were analyzed. The change of logMAR BCVA and the mean number of injection for each group were examined.

Results : 41 eyes in Group1, 22 eyes in Group2 and 13 eyes in Group3 were included. The mean logMAR BCVA was 0.27, 0.37 and 0.61 at baseline, 0.18, 0.23 and 0.52 at 1-year follow-up, 0.19, 0.22 and 0.67 at 2-year follow-up in group 1, group 2 and group 3, respectively. Visual acuity was significantly improved at 1-year and 2-year follow-up in Group1 and Group2 (Group1: P<0.01, P<0.05, Group 2: P<0.05, P<0.01, respectively, Wilcoxon signed-ranks test). No significant changes in mean visual acuity in Group3 (P=0.27, 0.53, respectively).
Mean number of IVA were 8.14, 7.7 and 5.5 through the first year, and 5.6, 2.5 and 3.1 through the second year in group 1, group 2 and group 3, respectively;the number of IVA increased in a period of continuing TAE.

Conclusions : To continue TAE at least for 1 year for improving visual acuity significantly is needed.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

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