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Maria K Gemenetzi, Praveen Patel, Shweta Anand, Marko Lukic, Simona Degli Esposti, Pearse Andrew Keane, Ella Preston, Robin Hamilton; A Retrospective Study of Real World Data for stable wet AMD treatment with aflibercept. Invest. Ophthalmol. Vis. Sci. 2019;60(9):1162.
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© ARVO (1962-2015); The Authors (2016-present)
To determine stability of visual acuity (VA) and retinal morphology in eyes with neovascular age-related macular degeneration (nAMD) after extending treatment intervals beyond 10 weeks.
Electronic medical records VA and retinal imaging data review of patients at Moorfields Eye Hospital with nAMD treated with aflibercept intravitreal injections from January 2013 onwards, who had at least 7 injections during the first year of treatment and received treatment of at least 2 years duration (fixed dosing in year 1 followed by treat & extend). We identified eyes which reached at least one 10 weeks treatment interval, then went on to longer treatment intervals. Definition of active phase of treatment: first injection to first 10-week treatment visit. Stable phase of treatment: first extension of treatment intervals over 10 weeks to final follow-up.
Of 1003 eligible eyes, 200 eyes had at least one extended >10 weeks interval and were included in the analysis. Mean age: 78 years. 67% female, 33% male. Mean total follow up time: 177 weeks (3.4 years). Mean interval in the active phase of treatment: 72 weeks. Mean interval in the stable phase of treatment: 104 weeks. Mean number of injections in the first year: 8. Mean number of injections in the second year: 5. Mean number of injections after stabilization: 9. Mean baseline VA: 54 ETDRS letters. Mean VA at the first visit of the stable phase: 62 ETDRS letters. Mean VA at the last follow up: 58 ETDRS letters. Proportion of eyes with stable vision (<15 letters loss): 81.5% and 80% in the active and stable phase respectively. Proportion of eyes with IRF on OCT at the first visit of the stable phase:61%. Proportion of eyes with IRF at the last follow up:52%. 67% of eyes with ≥15 letters loss since baseline had IRF on OCT at the first visit of the stable phase. 45% of eyes with ≥15 letters loss since baseline had IRF on OCT at the last follow up.
In aflibercept treated nAMD eyes where an extension in treatment intervals beyond 10 weeks was possible, we defined active and stable phases of treatment. The proportion of eyes with VA loss of <15 ETDRS letters was similar in the active and stable phases of treatment despite the high proportion of eyes with IRF on OCT post stabilisation. In the ‘’real world’’ IRF may not be a crucial prognostic factor for VA change in the long term when treatment with anti-VEGF is sustained.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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