July 2019
Volume 60, Issue 9
Free
ARVO Annual Meeting Abstract  |   July 2019
Individualizing therapy for neovascular age-related macular degeneration with aflibercept (the VITAL study): A two year prospective, interventional single-centre trial
Author Affiliations & Notes
  • Simona Degli Esposti
    NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
    Medical Retina Department, Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
  • Maria K Gemenetzi
    NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
    Medical Retina Department, Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
  • Maria Eleftheriadou
    NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
    Cataract Department, Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
  • Hari Jayaram
    NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
  • Bishwanath Pal
    NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
    Medical Retina Department, Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
  • Niaz Islam
    Cataract Department, Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
    Medical Retina Department, Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
  • Peter Addison
    NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
    Medical Retina Department, Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
  • Robin Hamilton
    NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
    Medical Retina Department, Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
  • Praveen Patel
    NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
    Medical Retina Department, Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
  • Footnotes
    Commercial Relationships   Simona Degli Esposti, Allergan (R); Maria Gemenetzi, None; Maria Eleftheriadou, None; Hari Jayaram, None; Bishwanath Pal, None; Niaz Islam, Bayer (R); Peter Addison, Bayer (R); Robin Hamilton, Allergan (R), Bayer (R), Ellex (R), Novartis (R); Praveen Patel, Bayer UK (F), Bayer UK (C), Novartis UK (C), Oxford Bioelectronics (C), Roche UK (C)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 85. doi:
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      Simona Degli Esposti, Maria K Gemenetzi, Maria Eleftheriadou, Hari Jayaram, Bishwanath Pal, Niaz Islam, Peter Addison, Robin Hamilton, Praveen Patel; Individualizing therapy for neovascular age-related macular degeneration with aflibercept (the VITAL study): A two year prospective, interventional single-centre trial. Invest. Ophthalmol. Vis. Sci. 2019;60(9):85.

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

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Abstract

Purpose : To report the mean change in Early Treatment Diabetic Retinopathy Study (ETDRS) best-corrected visual acuity (BCVA) and reading performance (reading acuity and maximum reading speed, MRS, using the MNREAD test) between baseline and 24 months in treatment naïve neovascular age-related macular degeneration (nAMD) patients treated with intravitreal aflibercept injections.

Methods : A prospective, open-label, interventional non-randomised case series with 24 months follow-up. (ClinicalTrials.gov Identifier: NCT02441816).
Patients were recruited to the study from medical retina clinics at Moorfields Eye Hospital. Intravitreal injections of 2.0 mg aflibercept in the study eye were administered using a fixed dosing regimen during the first year and a treat and extend treatment regimen during the second year of treatment.

Results : Of the 50 patients recruited at baseline, the mean age (SD) of patients was 78.7 (7.6) years at baseline with a mean BCVA of 62.8 letters, mean reading acuity of 0.52, mean MRS of 141.3 and a central retinal thickness (CRT) of 322.6 µm. Forty-six patients (92%) completed year 2 follow-up and the mean improvement in BCVA was 6.4 letters. The proportion of male to female patients for participants who had the 2 years assessment (n=46) was 30% to 70% respectively and mean change in reading acuity was an improvement of 0.13 logMAR units with an improvement in MRS of 2.9 words per minute. The mean reduction in CRT from baseline was 104.8 µm.

Conclusions : The treatment strategy of fixed dosing followed by treat and extend using aflibercept injections for nAMD led to improvements in BCVA and reading performance which were maintained at 2 years of follow-up.

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

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