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Katja B Hatz, Christian Pruente; Treat and Extend regimen versus Pro Re Nata regimen in a comparative study of ranibizumab in exudative age-related macular degeneration: 12 months results. Invest. Ophthalmol. Vis. Sci. 2014;55(13):3931.
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The purpose of this study was to compare the Treat and Extend (TE) regimen and the Pro Re Nata (PRN) regimen in ranibizumab treatment of neovascular age-related macular degeneration (wAMD).
Data of 140 eyes with treatment-naïve wAMD were analyzed retrospectively: Two groups of 70 consecutive patients each were treated with 0.5mg ranibizumab intravitreally following either the TE or the PRN regimen. PRN treatment was based on monthly optical coherence tomography (OCT) evaluation; retreatment was applied in case of reoccurrence of intra- or subretinal fluid or hemorrhages. In the TE regimen treatment intervals were sequentially lengthened by 2 weeks, starting at 4 weeks, until signs of CNV activity recurred. We compared the mean gains in best corrected visual acuity (VA) as well as the mean oscillation in VA (difference of best and worst VA) and the mean numbers of injections and vists.
Groups were well balanced for baseline characteristics like mean age (79 vs. 79 years) and baseline VA (0.39 = 20/51vs. 0.39 = 20/51). At 12 months, the mean gain in VA was significantly greater in the TE group than in the PRN group (+0.17±0.17 vs. +0.06±0.20, p=0.001) and VA oscillation was significantly lower for the TE eyes within the intervals baseline-6months and 6months-12months (0.12±0.10 vs. 0.21±0.12 and 0.07±0.08 vs. 0.17±0.16, p<0.001 and p=0.005, respectively). The eyes in the TE group received significantly more injections during the 12 months follow-up (8.6±1.9 vs. 6.0±1.9, p<0.001) while the number of follow-up visits attended was higher in the PRN group (8.6±1.9 vs. 11.9±1.1, p<0.001). At 12 months, the mean maximum recurrence free interval in the TE group was 8.8±2.9 weeks.
Eyes treated according to the TE regimen had a better visual outcome and less VA oscillations compared to PRN treated eyes. They received more injections but with less follow-up visits.
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