Abstract
Purpose :
To show the characteristics and outcomes of neovascular age-related macular degeneration (nAMD) patients who had extended remission (ER) while on a modified pro re nata (PRN) treatment protocol.
Methods :
Retrospective case control study. ER was defined as the absence of intraretinal/ subretinal fluid (IRF/SRF) on optical coherence tomography, hemorrhage, and leakage on fluorescein angiography for 52 weeks. Matching nAMD patients who did not achieve ER were included in the control group. Cox regression analysis was fitted to identify predictors of the time to achieve ER and time to recurrence. A logistic regression analysis of baseline characteristics was used to identify predictors of achieving ER.
Results :
Of 830 eyes treated with anti-VEGF monotherapy, 77 eyes (9.2%) eyes achieved ER during a median of 236 weeks (range, 70-525 weeks) follow up. Cox regression analysis showed that ER was achieved faster in eyes with isolated IRF (HR, 2.05; 95% CI, 1.929–4.520; p=0.045) at baseline. Logistic regression analysis showed that Type 3 CNV (OR, 0.090; 95% CI, 0.021-0.382; p=0.001), thinner choroidal thickness (OR, 0.993; 95% CI, 0.988-0.998; p=0.004) and absence of macular atrophy (OR, 0.233; 95% CI, 0.065-0.839; p=0.026) at baseline increased the likelihood of achieving ER.
Conclusions :
ER is achievable in 9.2% of patients under PRN therapy for nAMD. Presence of isolated IRF at baseline predicted shorter time to remission. The presence of type 3 CNV, thinner choroid and absence of macular atrophy at baseline increases the likelihood of achieving ER when treating AMD-associated CNV using a PRN regimen.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.