July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Twenty-four month outcomes of inflammatory choroidal neovascularization treated with intravitreal anti vascular endothelial growth factors: a comparison between two treatment regimens
Author Affiliations & Notes
  • Alessandro Invernizzi
    Eye Clinic, University of Milan, Fairlight, New South Wales, Australia
    Save Sight Institute, University of Sydney, Sydney, New South Wales, Australia
  • Francesco Pichi
    Cleveland Clinic, United Arab Emirates
  • Richard Symes
    Save Sight Institute, University of Sydney, Sydney, New South Wales, Australia
  • Sophia Zagora
    Save Sight Institute, University of Sydney, Sydney, New South Wales, Australia
  • Vuong Nguyen
    Save Sight Institute, University of Sydney, Sydney, New South Wales, Australia
  • Stefano Erba
    Eye Clinic, University of Milan, Fairlight, New South Wales, Australia
  • Alba Xhepa
    Eye Clinic, University of Milan, Fairlight, New South Wales, Australia
  • Luca De Simone
    Ocular Immunology Service, Azienda USL IRCCS, Reggio Emilia, Italy
  • Luca Cimino
    Ocular Immunology Service, Azienda USL IRCCS, Reggio Emilia, Italy
  • Mark C Gillies
    Save Sight Institute, University of Sydney, Sydney, New South Wales, Australia
  • Peter J McCluskey
    Save Sight Institute, University of Sydney, Sydney, New South Wales, Australia
  • Footnotes
    Commercial Relationships   Alessandro Invernizzi, Allergan (F); Francesco Pichi, None; Richard Symes, None; Sophia Zagora, None; Vuong Nguyen, None; Stefano Erba, None; Alba Xhepa, None; Luca De Simone, None; Luca Cimino, Abbvie (C), Santen (C); Mark Gillies, Allergan (C), Allergan (R), Bayer (R), Bayer (C), Novartis (C), Novartis (R), Ophtea (C), Ophtea (R); Peter McCluskey, AbbVie (R), AbbVie (F), AbbVie (C), Allergan (F), Allergan (C), Allergan (R), Shire (C), Shire (R), Zeiss (F)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 3859. doi:https://doi.org/
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      Alessandro Invernizzi, Francesco Pichi, Richard Symes, Sophia Zagora, Vuong Nguyen, Stefano Erba, Alba Xhepa, Luca De Simone, Luca Cimino, Mark C Gillies, Peter J McCluskey; Twenty-four month outcomes of inflammatory choroidal neovascularization treated with intravitreal anti vascular endothelial growth factors: a comparison between two treatment regimens. Invest. Ophthalmol. Vis. Sci. 2019;60(9):3859. doi: https://doi.org/.

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

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Abstract

Purpose : To compare two regimens of intravitreal anti-vascular endothelial growth factor (VEGF) injections for the treatment of inflammatory choroidal neovascularization (iCNV)

Methods : Eyes with iCNV treated with anti-VEGF injections between 2012 and 2016 at 5 referring centers with a follow-up of at least 12 months were recruited and divided into 2 groups according to treatment regimen. Eyes that received a loading phase of 3 monthly administered anti-VEGF injections and then were retreated as needed were included as the “LOADING” group. Eyes treated with one injection and then as needed were included as the “PRN” group. Differences in best correct visual acuity (BCVA), number of injections received and number of CNV recurrences at 12 and 24 months were compared between the groups. Age, gender, baseline BCVA and immunosuppressive treatment were also compared.

Results : Ninety-three eyes (93 patients) were included, 43 in the LOADING and 50 in the PRN group. Baseline BCVA (mean[SD]) was not significantly different between the LOADING and PRN group (71.7[16.8] vs 78.1[15.6] letters, p=0.07). The BCVA change (mean[95% CI]) from baseline at three months was 15.6[11.8–19.5] letters in the LOADING (p<0001) and 11.6[7.4 –15.7] letters in the PRN group (p<0.001). This improvement was maintained over the entire follow-up in both groups (all p<0.001). There was no difference in BCVA (mean[SD]) between the LOADING and the PRN groups at 12 (86.8[13.2] vs 91.7[11.8] letters, p=0.47) and 24 (87.2[15.8] vs 89.6[12.5] letters, p=0.71) months. The LOADING group received significantly more injections (median[Q1-Q3]) than the PRN at 12 (4[3-6] vs 2[1-3] injections, p<0.0001) and 24 (4[3-6.7] vs 2.5[2-3] injections, p<0.0001) months. The number of recurrences of CNV activity was similar in both groups at 12 and 24 months (both p>0.92).

Conclusions : Inflammatory CNV responded well to anti-VEGF injections with prompt and sustained improvement in BCVA. The loading phase of three injections did not confer any advantage in terms of outcomes or number of recurrences. PRN anti-VEGF treatment regimen from the beginning was as effective as more intensive anti-VEGF treatment.

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

 

Visual outcomes over 24 months (A) and difference in the number of letters read from baseline (B) in eyes with iCNV treated with 2 different regimens of anti-VEGF injections.

Visual outcomes over 24 months (A) and difference in the number of letters read from baseline (B) in eyes with iCNV treated with 2 different regimens of anti-VEGF injections.

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