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A. Takserman, H. F. Ulltveit-Moe, P. Bjerga, L. T. Hashemi, S. Raeder, V. A. Forsaa; The Effect of VEGF Inhibitors Administrated on "Inject and Extend" Dosing Strategy in Patients Treated for Unilateral CNV and New-Onset CNV in the Fellow Eye. Invest. Ophthalmol. Vis. Sci. 2010;51(13):86.
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To compare the effectiveness of intravitreal vascular endothelial growth factor (VEGF) inhibitors in patients treated for unilateral subfoveal choroidal neovascularizaion (CNV) to new-onset subfoveal CNV in the fellow eye.
We performed a retrospective observational study of 20 eyes of 10 patients with subfoveal CNV treated with intravitreal bevacizumab 1.25 mg (n=8) or ranibizumab 0.5 mg (n=12) on "inject and extend" dosing strategy. Inclusion criterias were new-onset subfoveal choroidal neovascularization in the fellow eye and a follow-up of minimum six months. The mean delay in treatment between first and fellow eyes was 12 months (range, 2-27 months). Ophthalmologic evaluations at each treatment included visual acuity (VA) and optical coherence tomography imaging. VA and central macular thickness (CMT) were compared using Mann-Whitney U test, and a p-value of 0.05 was considered significant.
The mean number of injections during six months follow-up was 6.1 in first eyes and 5.9 in fellow eyes. At baseline mean VA in fellow eyes (0.38±0.21 logMAR) was significantly higher (p=0.03) than mean VA in first eyes (0.62±0.18 logMAR). At 6-months follow-up, a significant difference (p=0.002) was found when comparing VA in fellow eyes (0.19±0.12 logMAR) with VA in first eyes (0.41± 0.18 logMAR). Mean CMT at baseline was 347±119 µm in first eyes and 322±72 µm in fellow eyes. A reduction of CMT was registered for both groups, with a mean CMT of 265±84 µm in first eyes and 211±35 µm in fellow eyes. No significant difference in CMT was disclosed when comparing first and second eyes at baseline and at 6-months follow-up.
Patients with new-onset subfoveal CNV in fellow eyes present a better VA when diagnosed than first eyes and have a significantly better VA and greater improvement in optical coherence tomography parameters at six months treatment with VEGF inhibitors on "inject and extend" dosing strategy.
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