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Kyo Akika, Manabu Yamamoto, Ayako Yasui, Kumiko Hirayama, Takeya Kohno, Kunihiko Shiraki; Two-year Results of “Treat and Extend” Intravitreal Aflibercept Injection for Exudative Age-related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2016;57(12):2667. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate 2-years results of “treat and extend” (TAE) intravitreal Aflibercept injection (IVA) for exudative age-related macular degeneration (AMD) in Japanese.
Subjects comprised 76 eyes of 76 patients (50 males and 26 females women) treated with IVA using TAE regimen for treatment-naïve AMD at Department of Ophthalmology, Osaka City University Hospital between February 2013 and September 2013, for whom at least 2 year had elapsed since treatment. Mean age was 74 years old (range 49-92). Best corrected visual acuity (BCVA) examination, fluorescein angiography, indocyanine green angiography and optical coherence tomography (OCT) were performed at baseline. Patients were treated with 3 monthly (4-5 weeks) injection for loading phase, and they were followed by extension of the treatment interval by 2 weeks (up to maximum 13 weeks) provided there were no signs of exudate in OCT. If signs of activity were detected, treatment intervals were shortened to 5 weeks.Patients out of continuing TAE were changed to the Pro Re Nata (PRN) protocol. Patients were classified into 3 groups; eyes treated with TAE for 2 years completely (Group1), eyes treated with TAE for more than 1 year (Group2) and eyes treated with TAE for less than 1 year (Group3) and were analyzed. The change of logMAR BCVA and the mean number of injection for each group were examined.
41 eyes in Group1, 22 eyes in Group2 and 13 eyes in Group3 were included. The mean logMAR BCVA was 0.27, 0.37 and 0.61 at baseline, 0.18, 0.23 and 0.52 at 1-year follow-up, 0.19, 0.22 and 0.67 at 2-year follow-up in group 1, group 2 and group 3, respectively. Visual acuity was significantly improved at 1-year and 2-year follow-up in Group1 and Group2 (Group1: P<0.01, P<0.05, Group 2: P<0.05, P<0.01, respectively, Wilcoxon signed-ranks test). No significant changes in mean visual acuity in Group3 (P=0.27, 0.53, respectively).Mean number of IVA were 8.14, 7.7 and 5.5 through the first year, and 5.6, 2.5 and 3.1 through the second year in group 1, group 2 and group 3, respectively;the number of IVA increased in a period of continuing TAE.
To continue TAE at least for 1 year for improving visual acuity significantly is needed.
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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