Abstract
Purpose:
To study the effects on visual acuity, rhythm of intravitreal injections and number of clinical examinations in a real-life “observe and plan” individual treatment regimen with aflibercept for neovascular forms of macular aged-related degeneration (nAMD).
Methods:
This was a french monocentric retrospective study that included 33 eyes (27 patients) with nAMD. After three loading intravitreal injections of aflibercept, patients underwent a monthly follow up with SD OCT allowing to determine for each, the first disease recurrence interval. We planned a personalized retreatment regimen considering the retreatment interval was the first disease recurrence interval for the following injections. Periodical visits assessed the effectiveness of the treatment. Data on best corrected visual acuity (BCVA), number of injections and visits was collected for 12 months.
Results:
26 eyes (79%) were switched from ranibizumab while 7 eyes (21%) were naive from aflibercept. The BCVA remained stable. Initial BCVA was 68,2 letters (ETDRS) and final BCVA after 12 months was 66,8 letters (ETDRS) with no significative difference (p > 0.05). Mean retreatment interval was 8.2 weeks. An mean of 7.6 aflibercept injections and 6.9 clinical examinations were performed during 12 months.<br /> The retreatment interval was modified for 50 pct of the eyes . For these ones, we found a small intra-individual variability. There was a stable rhythm of injections for a given patient.
Conclusions:
In this study we observed stable BCVA and less injections and follow-up examinations than in other existing treatment protocols. Personalized “observe & plan” treatment regimen for nAMD shows encouraging results and could reduce the clinical burden of nAMD management while maintaining satisfactory functional results.