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Manabu Yamamoto, Takeya Kohno, Kumiko Hirayama, Shigeru Honda; Predictors of five-year visual outcome for exudative age-related macular degeneration treated with intravitreal aflibercept using treat and extend regimen.. Invest. Ophthalmol. Vis. Sci. 2019;60(9):118.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the predictors of five-year visual outcome for exudative age-related macular degeneration (AMD) treated with intravitreal aflibercept (IVA) using treat and extend regimen (TAE).
Subjects comprised 48 eyes of 48 patients (28 males and 20 females) treated with IVA using TAE regimen for treatment-naïve AMD at Department of Ophthalmology, Osaka City University Hospital between February 2013 and October 2013, for whom 5 year had elapsed since treatment. Mean age was 73 years old (range 49-92). The best corrected visual acuity (BCVA) examination, fluorescein angiography, indocyanine green angiography and optical coherence tomography (OCT) were performed at baseline. Patients were treated with 3 monthly (4-5 weeks) injection for loading phase, and they were followed by extension of the treatment interval by 2 weeks (up to maximum 13 weeks) provided there were no signs of exudate in OCT. If signs of activity were detected, treatment intervals were shortened to 5 weeks. Patients were classified into 3 groups; eyes successfully treated with TAE for 5 years (Group 1), eyes treated with TAE for less than 5 years (Group 2) and eyes converted to or combined with photodynamic therapy (PDT) (Group 3) and were analyzed. BCVA was measured using Landolt C chart and converted to logarithm minimum angle resolution (logMAR) for calculation.
Group 1, 2 and 3 included 17 eyes (35%), 26 eyes (54%) and 5 eyes (10%), respectively. In Group 2, TAE was performed in the average of 17 months (range 3-37 months). In Group 3, the average time to apply PDT was 32 months (range 16-40 months).The BCVA was changed from 0.30 to 0.16 in Group 1, 0.31 to 0.41 in Group 2 and 0.30 to 0.11 in Group 3, with no significant difference (Group 1: p=0.15, Group 2: p=0.66, Group 3: p=0.72). A baseline BCVA and a duration of TAE were identified as independent factors significantly associated with the final BCVA using the multivariate analysis (R2=0.33, p<0.01).
The present study suggested that a good baseline BCVA and continuation of TAE were associated with a good visual prognosis.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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