July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Efficacy of the Treat-and-Extend Regimen in the Management of Neovascular Age-related Macular Degeneration: 5-year Results of the RENO Study
Author Affiliations & Notes
  • Jonathan Dang
    University of Nevada, Reno School of Medicine, Reno, Nevada, United States
  • Arshad M. Khanani
    Sierra Eye Associates, Reno, Nevada, United States
  • Greggory Gahn
    University of Nevada, Reno School of Medicine, Reno, Nevada, United States
  • Micaela Koci
    University of Nevada, Reno School of Medicine, Reno, Nevada, United States
  • Nazrul Mojumder
    University of Nevada, Reno School of Medicine, Reno, Nevada, United States
  • Sylvia Phillips
    Sierra Eye Associates, Reno, Nevada, United States
  • Lauren Hill
    Independent Statistical Consultant, Denver, Colorado, United States
  • Footnotes
    Commercial Relationships   Jonathan Dang, None; Arshad Khanani, Aerpio (F), Aerpio (C), Alimera (C), Allergan (F), Allergan (C), Allergan (R), Clearside (F), Genentech (C), Genentech (R), Genentech (F), Neurotech (F), Novartis (F), Novartis (R), Novartis (C), Ophtea (C), Ophthotech (F), Opthea (F), Oxurion (F), Oxurion (C), Polyphotonix (C), Recent Medical (F), Recent Medical (C), Roche (C), Santen (C), Verana Health (F); Greggory Gahn, None; Micaela Koci, None; Nazrul Mojumder, None; Sylvia Phillips, None; Lauren Hill, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 101. doi:
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      Jonathan Dang, Arshad M. Khanani, Greggory Gahn, Micaela Koci, Nazrul Mojumder, Sylvia Phillips, Lauren Hill; Efficacy of the Treat-and-Extend Regimen in the Management of Neovascular Age-related Macular Degeneration: 5-year Results of the RENO Study. Invest. Ophthalmol. Vis. Sci. 2019;60(9):101.

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

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Abstract

Purpose : 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.

Methods : This is a retrospective, interventional, consecutive case series. A total of 165 eyes from 137 treatment-naïve patients diagnosed with nAMD diagnoses after August 2010 were included, with data collection through August 2018. 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. Patients needed to receive a minimum of 6 injections in the first year and at least 3 injections in the following years to be included in this study. 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.

Results : The average (standard deviation [SD]) patient age was 82 years (8.4); 59% of patients were female. The mean follow-up period was 3.3 years (median, 3 years), with 165, 131, 117, 81, and 48 eyes completing 1, 2, 3, 4, and 5 years of follow-up, respectively. The average BCVA at baseline was 53.2 letters. Mean (SD) changes from baseline in BCVA at years 1, 2, 3, 4, and 5 were gains of 8.2 (23.1) letters, 7.4 (27.8) letters, 6.9 (29.0) letters, 7.4 (26.2) letters, and 5.9 (30.4) letters, respectively. The median number of injections received by patients in each year was 8, 6, 5, 6, and 5 for years 1, 2, 3, 4, and 5, respectively. At the final follow-up, 17.0% of eyes had lost ≥ 15 letters, and 30.3% of eyes had gained ≥ 15 letters.

Conclusions : 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 in patients who received a minimum of 6 injections in the first year.

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

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