July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Comparison of Outcomes in Patients with Neovascular Age-Related Macular Degeneration Managed with Anti-VEGF on Conventional Treat-and-Extend vs. Trial-Stop Regimens
Author Affiliations & Notes
  • Christina Y Weng
    Retina, Baylor College of Medicine-Cullen Eye Institute, Houston, Texas, United States
  • Weijie Violet Lin
    Baylor College of Medicine, HOUSTON, Texas, United States
  • Footnotes
    Commercial Relationships   Christina Weng, None; Weijie Violet Lin, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 841. doi:https://doi.org/
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      Christina Y Weng, Weijie Violet Lin; Comparison of Outcomes in Patients with Neovascular Age-Related Macular Degeneration Managed with Anti-VEGF on Conventional Treat-and-Extend vs. Trial-Stop Regimens. Invest. Ophthalmol. Vis. Sci. 2018;59(9):841. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose : To analyze outcomes for neovascular age-related macular degeneration (NVAMD) treated with intravitreal anti-vascular endothelial growth factor (anti-VEGF) on a treat-and-extend (TAE) basis vs. trial-stop (TS) regimen.

Methods : Retrospective study of NVAMD patients treated with anti-VEGF from 2014-2017. Included patients had reached stability (defined by no fluid on optical coherence tomography (OCT)) on a TAE protocol and a) were receiving injections every 12 weeks or b) once reaching an interval of 12 weeks, elected to proceed with a TS where they were evaluated every 12 weeks, but did not receive an injection unless fluid recurred. Unpaired/paired t-tests and difference-in-differences analysis were used. Statistical significance was defined as p-value <0.05.

Results : Twenty-one eyes of 16 patients were included. Five eyes were injected every 12 weeks while 16 were on a TS regimen. Overall mean duration of follow-up after reaching a 12-week interval was 17.8 months. Prior to TS, an average of 8.46 anti-VEGF injections were given, with an average 3.92 injections while OCT was stable.

The TS group did not show significant changes in logMAR Va (visual acuity) or CFT (central foveal thickness) between the point of TS initiation and 6 months post-TS initiation. Similarly, the TAE group did not show significant changes in these two parameters between the point of reaching 12-week intervals and 6-months after this point.

In comparing the two groups (TS at time of TS initiation vs. TAE at time of reaching 12-week interval), differences in mean CFT (TS 275.5µ vs TAE 288.4µ) and logMAR Va (TS 0.52 vs TAE 0.52) were not significant. These two parameters also did not show significant differences when compared 6 months after these two defined points. No significant differences in mean final Va were found, but interestingly, mean final CFT values in the TS group were significantly lower (p=0.04) than in the TAE group.

Conclusions : Patients with stable NVAMD treated on a TS regimen did not experience significant vision loss or anatomical thickening. Moreover, they did not show inferior visual or anatomic outcomes compared to counterparts on a TAE regimen. When CFT stability is reached during the management of NVAMD with anti-VEGF therapy, a trial-stop may be a safe consideration.

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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