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Scott Oliver, Richard Yi-Jen Hwang; Wet AMD recurrence rate in patients on 3 months interval anti-vegf therapy in a single community practice. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):5381.
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© ARVO (1962-2015); The Authors (2016-present)
To determine wet AMD recurrence rate in patients on 3 months anti-vegf therapy in a single community practice.
A two year retrospective chart review of a single physician at a single practice of all wet AMD patients treated (ICD9 362.52) with anti-vegf therapy was performed. Patients were typically treated using a “treat and extend” methodology. Charts were evaluated for anti-vegf therapy, treatment interval, duration of treatment, trials off of anti-vegf therapy and AMD recurrence. AMD recurrence was defined as an increase in intra-retinal or subretinal fluid on OCT or presence of new subretinal retinal blood on exam per the physician’s evaluation. Patients on a 3 month interval treatment were defined as having no recurrence who have been extended to 3 months with at least one 3 month interval follow up while on anti-VEGF therapy.
321 wet AMD patients were seen over a two year interval from 2012 through 2014. 76 patients were on 3 month interval maintenance anti-vegf therapy. 9 of these patients were excluded based on incomplete data or follow up. The remaining 67 patients included 73 eyes on 3 month interval anti-vegf therapy of which 9 eyes had begun trials off of 3 month maintenance therapy. The remaining 64 eyes on 3 months interval treatments had an overall 14% recurrence of wet AMD (9/63) from 2012-2014. Mean interval of eyes on maintenance without recurrence (52/63=86%) was 64 +/- 7 (average +/- SEM) weeks and mean interval until recurrence was 93 +/- 24 weeks. Kaplan meier plot of data suggests a low rate of AMD recurrence rate within the first 3 years on maintenance therapy but an increased recurrence rate after 3 years.
Evaluation of a treat and extend methodology of treating wet AMD in this single community practice suggests that if a patient can be extended to 3 month intervals, there is a high relatively low chance of recurrence during the first 3 years on maintenance. Further data analysis are needed to identify factors related to recurrence.
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