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David S. Dyer, Michael P. Ellis, Lindsey D. Dyer, William J. Anderson; 2 Year Follow-up of Enhanced Induction/Maintenance Therapy for Neovascular Age-Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2012;53(14):5171.
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To assess the long-term effectiveness and safety of an induction/maintenance regimen involving the sequential administration of nonselective and selective anti-vascular endothelial growth factor (VEGF) therapies in neovascular age-related macular degeneration (NV-AMD).
A retrospective chart review of consecutive NV-AMD cases treated with an anti-VEGF induction/maintenance regimen for 24 months. Induction therapy with either intravitreal ranibizumab or bevacizumab was administered until there was no leakage on fluorescein angiography and/or no fluid on optical coherence tomography. Maintenance therapy with intravitreal pegaptanib 0.3 mg was to be administered every 6 weeks, with booster treatments of ranibizumab at the investigator’s discretion for worsening NV-AMD. Safety data was self-reported to nurses at the beginning of each visit. All clinical work was performed by one retina specialist at our multi-center retina practice.
In all, 154 eyes met criteria for inclusion in the analysis and received a mean of 3.5 ±1.3 induction and 11.4±2.4 maintenance injections. Preinduction to the last visit, 122/154 (79.2%) eyes avoided losing 3 or more lines and 40/154 (26%) gained 3 or more lines. Booster injections were required in 61/154 (39.6%) eyes. Safety data will be presented with the poster.
A regimen involving an initial induction phase with nonselective anti-VEGF agents to eliminate retinal edema followed by maintenance pegaptanib was effective in maintaining visual acuity in NV-AMD. In addition, rates of serious systemic and ocular adverse events were low during the two years of treatment.
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