July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Treat-and-extend anti-VEGF therapy for exudative age-related macular degeneration: long-term results
Author Affiliations & Notes
  • Sandra DELAUNAY
    Retinal department, Institut Ophtalmologique de l'Ouest - Clinique Jules Verne, Nantes, France
  • Frank Becquet
    Retinal department, Institut Ophtalmologique de l'Ouest - Clinique Jules Verne, Nantes, France
  • Sophie Dupouy
    Retinal department, Institut Ophtalmologique de l'Ouest - Clinique Jules Verne, Nantes, France
  • Elisabeth Hermouet-Leclair
    Retinal department, Institut Ophtalmologique de l'Ouest - Clinique Jules Verne, Nantes, France
  • Idriss Badat
    Retinal department, Institut Ophtalmologique de l'Ouest - Clinique Jules Verne, Nantes, France
  • Jean-François Le Rouic
    Retinal department, Institut Ophtalmologique de l'Ouest - Clinique Jules Verne, Nantes, France
  • Footnotes
    Commercial Relationships   Sandra DELAUNAY, None; Frank Becquet, Novartis (R); Sophie Dupouy, None; Elisabeth Hermouet-Leclair, None; Idriss Badat, None; Jean-François Le Rouic, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 100. doi:
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      Sandra DELAUNAY, Frank Becquet, Sophie Dupouy, Elisabeth Hermouet-Leclair, Idriss Badat, Jean-François Le Rouic; Treat-and-extend anti-VEGF therapy for exudative age-related macular degeneration: long-term results. Invest. Ophthalmol. Vis. Sci. 2019;60(9):100.

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

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Abstract

Purpose : To compare visual outcomes with a 5-year minimum follow-up of anti-vascular endothelial growth factor (VEGF) therapy using a treat-and-extend (TE) regimen to a non TE regimen, in naïve patients with exudative age-related macular degeneration (eAMD)

Methods : Charts analysis of 257 eyes from 219 patients diagnosed with eAMD and treated between January 2008 and December 2017 were included. Treatment was initiated with either ranibizumab or other anti-VEGF agents for a minimum of 5 years, using or not a TE regimen. The patients' baseline visual acuity (VA; Early Treatment Diabetic Retinopathy Study [ETDRS] letters), age, length of follow-up, anti-VEGF agents used, and interval between treatments were obtained. All data were collected retrospectively using GraphPad Prism (GraphPad Software, USA). Statistical analysis of the study data were performed with GraphPad Prism (GraphPad Software, USA) and BiostaTGV (Inserm, France) using the Mann-Whitney test

Results : Thirty two eyes of 31 naïve patients whose treatment was initiated with ranibizumab using a TE protocol (group 1) were compared to 225 eyes of 188 patients who were treated with anti-VEGF agents with a different protocol (group 2). Patient’s mean age was 75.6 years. Women represented 62.5% and 71,2% of the study population for group1 and group 2 respectively. Mean VA at baseline in group 1 was 66.6 ETDRS letters (59.7 for group 2, P = 0,086); it improved to 74.1 compared to 63.5 for group 2 (P < 0.001) after 1 year of treatment and was maintained at 76.2 (63.2 for group 2, P < 0.001) and 75.4 (58.7 for group 2, P < 0.01) after a 5- and 7-year follow-up, respectively. The mean duration of follow-up at the last visit was 6.65 years for group 1 versus 6.53 years for group 2 (P = 0.38). Patients received, on average, 8.6 injections per year for group 1 versus 4.8 for group 2 (P < 0.0001) during the whole follow-up. The mean interval between treatments at the last examination was 6.2 weeks for group 1 compared to 10.5 weeks for group 2 (P < 0.0001). At 5 years, 46,6% of eyes had gained ≥ 10 letters of VA in group 1 versus 32,1% in group 2 (P < 0.01)

Conclusions : At the expense of more injections, TE anti-VEGF therapy is effective for achieving and maintaining visual improvements in patients with eAMD for at least 5 years of treatment

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

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