June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Two-year outcome of aflibercept for treatment-naïve patient with neovascular age-related macular degeneration using modified treat-and-extend regimen
Author Affiliations & Notes
  • Masayuki Ohnaka
    Ophthalmology, Kansai Medical University, Hirakata, Japan
  • Yoshimi Nagai
    Ophthalmology, Kansai Medical University, Hirakata, Japan
  • Motoki Kimura
    Ophthalmology, Kansai Medical University, Hirakata, Japan
  • Tomoyuki Chihara
    Ophthalmology, Kansai Medical University, Hirakata, Japan
  • Kazuki Nakagawa
    Ophthalmology, Kansai Medical University, Hirakata, Japan
  • Kyoko Fujita
    Ophthalmology, Kansai Medical University, Hirakata, Japan
  • Kanji Takahashi
    Ophthalmology, Kansai Medical University, Hirakata, Japan
  • Footnotes
    Commercial Relationships   Masayuki Ohnaka, None; Yoshimi Nagai, None; Motoki Kimura, None; Tomoyuki Chihara, None; Kazuki Nakagawa, None; Kyoko Fujita, None; Kanji Takahashi, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 890. doi:
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    • Get Citation

      Masayuki Ohnaka, Yoshimi Nagai, Motoki Kimura, Tomoyuki Chihara, Kazuki Nakagawa, Kyoko Fujita, Kanji Takahashi; Two-year outcome of aflibercept for treatment-naïve patient with neovascular age-related macular degeneration using modified treat-and-extend regimen
      . Invest. Ophthalmol. Vis. Sci. 2017;58(8):890.

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

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Abstract

Purpose : We performed a retrospective, observational clinical study to evaluate a modified treat-and-extend (TAE) regimen of intravitreal aflibercept injection (IAI) for treatment-naïve patients with neovascular age-related macular degeneration (AMD).

Methods : We reviewed the eyes with treatment-naïve neovascular AMD which underwent an initial loading dose of at least three monthly intravitreal injections of aflibercept 2 mg, and completed 2 year follow up. Thirty-seven eyes were treated with the modified TAE regimen, and 39 eyes were treated with the pro re nata (PRN) dosing regimen. The modified TAE regimen consisted of three steps: 1) an induction phase, during which patients were treated with ≥3monthly IAIs until exudative activity disappeared, 2) an observation phase, during which patients were monitored until exudative activity appeared, and 3) a TAE phase, for which the initial treatment interval was determined based on the disease recurrence interval, followed by treatment intervals changing by 2 weeks.

Results : In the modified TAE group, 23 (24 eyes) were men, and 12 (13 eyes) were women. The mean patient age was 72.1±7.1 years (range, 53-85). Sixteen eyes had typical neovascular AMD and 21 eyes had polypoidal choroidal vasculopathy (PCV). Mean logMAR BCVA improved significantly from 0.46±0.46 at baseline to 0.36±0.51 at 24 months (P=0.008), and was maintained (losing <0.3 logMAR units) in 34 eyes (91.9%). In the TAE phase, the distribution of treatment intervals was ≥8 weeks in 75% (18 eyes) at 24 months. The mean number of injections was 4.65 in the first year and 3.67 in the second year. In the PRN group, 25 (25 eyes) were men, and 14 (14 eyes) were women. The mean patient age was 72.7±7.1 years (range, 53-86). Twenty eyes had typical neovascular AMD and 19 eyes had PCV. Mean logMAR BCVA improved significantly from 0.39±0.48 at baseline to 0.32±0.47 at 12 months (P=0.04), but declined to 0.35±0.47 at 24 months (P=0.15). Mean logMAR BCVA was maintained in 35 eyes (89.7%). The mean number of injections was 4.26 in the first year and 1.31 in the second year. In both groups, the mean central retinal thickness and central choroidal thickness decreased significantly after 24 months.

Conclusions : A modified TAE regimen of IAI for neovascular AMD produced good functional outcomes over 24 months with the relatively small number of injections.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

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