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.