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Hussein Almuhtaseb, James S Talks, Rob Johnston, Andrew J Lotery; 2nd Year Visual Acuity Outcomes of AMD patients treated with Aflibercept : Data Analysis from the UK Aflibercept users group. Invest. Ophthalmol. Vis. Sci. 2016;57(12):545. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
The VIEW 1 and 2 trials year 1 protocol has been adopted by many NHS centres. Conversely the year 2, a capped PRN regimen with monthly visits has not been widely adopted in the NHS due to health resources needed. We audited the visual outcomes achieved at the end of year two of therapy with aflibercept in 16 UK centres to see what year 2 outcomes were achieved when different treatment approaches were adopted.
Retrospective data analysis from an electronic medical record (EMR) system (Medisoft Ophthalmology) extracted from 16 centres in the UK. A consecutive series of treatment-naïve nAMD patients who received aflibercept for 2 consecutive years. During year one treatment was given according to the VIEW 1 and 2 trials’ protocol. In year two, aflibercept was given according to an individualised treatment tailored to every patient’s needs.
655 eyes contributed to the data set. 537 eyes were 1st treated eyes, and 118 were 2nd treated eyes. A mean of 4.2 injections (range 1-9) at a mean of 5.4 visits during the second year of treatment were observed. The mean baseline visual acuity (VA) at month 0 was 56L improving to 58L (+2L gain) at end of year 2. In 1st treated eyes the respective figures were: 55L at baseline, and 57L at end of year 2, +2L gain.In 2nd treated eyes the respective figures were: 58L at baseline, and 59L at year 2, +1L gain . The proportion achieving 70L or more was 31%. 71.29 % avoided moderate visual loss. The mean number of intravitreal injections (IVI)s during year 2 in 1st and 2nd treated eyes was 4 IVIs. Patients were stratified by number of IVIs into 3 groups: group A-36% of patients (</= 3 IVIs) ; group B-36% of patients (4-5 IVIs); group C-28% of patients (6-9 IVIs). The mean VA at month 24 of groups A, B and C was 56, 59 and 63 L respectively. Eyes that received 6-9 IVIs (group 3) showed significantly higher mean visual acuity at month 24 than those that received < 3 IVIs (group 1) [P <0.01]. The higher the number of IVIs given during year 2 the higher the visual acuity score at month 24 [P= 0.002].
Baseline VAs were maintained through the 2-year treatment plan. A proactive regimen involving a higher number of IVIs resulted in a better VA score at the end of year 2. These results demonstrate the need for aggressive treatment in year 2 to maintain the treatment gains achieved in year 1 of therapy with aflibercept.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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