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Micaela Koci, Greggory M Gahn, Peter D Freeman, Lauren Hill, Sarah A Taylor, Aamir Aziz, Arshad M. Khanani; Retrospective Evaluation of Neovascular Age-related Macular Degeneration Managed With Treat-And-Extend Regimen: 5-year Results of the RENO Study. Invest. Ophthalmol. Vis. Sci. 2018;59(9):810.
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This retrospective study evaluated real-world long-term visual outcomes using a treat-and-extend regimen with anti-VEGF agents for the treatment of neovascular age-related macular degeneration (nAMD). The treat-and-extend regimen is a commonly used approach amongst retina specialists for the treatment of nAMD. This study evaluated real-world treatment outcomes after 1 to 5 years of intravitreal ranibizumab, aflibercept, or bevacizumab using a treat-and-extend regimen in patients with nAMD in the United States.
This is a retrospective, interventional, consecutive case series. A total of 212 eyes from 183 treatment-naïve patients diagnosed with nAMD after August 2010 were included, with data collection through August 2017. All patients were treated at a single site by one physician with ranibizumab, aflibercept, or bevacizumab for ≥1 year using a treat-and-extend regimen. Snellen best-corrected visual acuity (BCVA) was converted to ETDRS letters using a standardized formula. The main outcome measures were: BCVA change from baseline to end of patient follow-up, mean number of injections per year, and proportion of eyes losing >15 letters or gaining >15 letters. Observed data are reported.
The average (standard deviation [SD]) patient age was 80 years (8.9); 59% of patients were female. The mean follow-up period was 3.3 years (median, 3 years), with 212, 205, 149, 85 and 51 eyes completing 1, 2, 3, 4, and 5 years of follow-up, respectively. The average BCVA at baseline was 51.0 letters. Mean (SD) increases from baseline in BCVA at years 1, 2, 3, 4, and 5 were 9.5 (22.9) letters, 7.9 (26.8) letters, 6.7(28.8) letters, 4.9 (26.2) letters, and 7.1 (30.5) letters, respectively. The median number of injections received by patients in each year was 7, 5, 5, 5, and 4 for years 1, 2, 3, 4, and 5 respectively. At the final follow-up, 16.5% of eyes had lost >15 letters, and 33.0% of eyes had gained >15 letters.
The treat-and-extend regimen was effective in achieving visual improvements in patients with nAMD with ranibizumab, aflibercept or bevacizumab for up to 5 years of treatment. In addition, it resulted in decreased treatment burden compared with monthly or fixed bimonthly dosing. Further studies are needed to confirm these findings.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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