June 2013
Volume 54, Issue 15
ARVO Annual Meeting Abstract  |   June 2013
Persistent Leakage During the Course of Anti-VEGF Monotherapy - Etiology and Treatment
Author Affiliations & Notes
  • Mark Nelson
    North Carolina Macular Consultants, Winston-Salem, NC
  • Footnotes
    Commercial Relationships Mark Nelson, None
  • Footnotes
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Investigative Ophthalmology & Visual Science June 2013, Vol.54, 3803. doi:https://doi.org/
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      Mark Nelson; Persistent Leakage During the Course of Anti-VEGF Monotherapy - Etiology and Treatment. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3803. doi: https://doi.org/.

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

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Purpose: Determine the cause of persistent leakage in patients treated with anti-VEGF monotherapy

Methods: Retrospective evaluation of 64 treatment-naive patients with Exudative ARMD who comprised two treatment groups: Monthly (24 months of monthly ranibizumab) and Treat and Extend (12 months of monthly ranibizumab, followed by 12 months of a 'treat and extend' protocol. Pre-treatment evaluation of each patient included ICG/IVFA/OCT multimodality imaging. Post-treatment followup included monthly OCT and every three month ICG imaging.

Results: 10% of patients from all groups were classified as Primary Anti-VEGF Failures (failed induction). 10% of patients in the Monthly group developed recurrent leakage, defined as a Secondary Anti-VEGF Failures. 20% of patients in the Treat and Extend group became Secondary Anti-VEGF Failures. All patients with recurrent leakage had ICG-identifiable lesions. All patients were treated with rescue protocols: increased ranibizumab frequency, aflibercept monotherapy, or ICG-Directed PDT Triple Therapy.

Conclusions: ICG multimodality imaging is critical to determine the etiology of the persistent leakage and to create a strategy for exudative and neovascular resolution.

Keywords: 412 age-related macular degeneration • 552 imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • 453 choroid: neovascularization  

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