June 2020
Volume 61, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2020
Efficacy of the Treat-and-Extend Regimen in the Management of Neovascular Age-related Macular Degeneration: 6-year Results of the RENO Study
Author Affiliations & Notes
  • Jordyn Vannavong
    Sierra Eye Associates, Reno, Nevada, United States
  • Jonathan Dang
    University of Nevada, Reno School of Medicine, Reno, Nevada, United States
  • Micaela M. Koci
    University of Nevada, Reno School of Medicine, Reno, Nevada, United States
  • Aamir Aziz
    Sierra Eye Associates, Reno, Nevada, United States
  • Fawwaz Siddiqui
    Sierra Eye Associates, Reno, Nevada, United States
  • Sylvia Phillips
    Sierra Eye Associates, Reno, Nevada, United States
  • Phoebe Shappell
    University of Southern California, Los Angeles, California, United States
  • Molly Hagen
    University of Nevada, Reno School of Community Health Sciences, Reno, Nevada, United States
  • Wei Yang
    University of Nevada, Reno School of Community Health Sciences, Reno, Nevada, United States
  • Jay Chhablani
    University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
  • Arshad M. Khanani
    Sierra Eye Associates, Reno, Nevada, United States
    University of Nevada, Reno School of Medicine, Reno, Nevada, United States
  • Footnotes
    Commercial Relationships   Jordyn Vannavong, None; Jonathan Dang, None; Micaela Koci, None; Aamir Aziz, None; Fawwaz Siddiqui, None; Sylvia Phillips, Genentech (C), Novartis (C); Phoebe Shappell, None; Molly Hagen, None; Wei Yang, None; Jay Chhablani, Allergan (C), Novartis (C); Arshad Khanani, Adverum (R), Adverum (C), Allergan (C), Allergan (S), Allergan (R), Genentech (C), Genentech (S), Genentech (R), Graybug (R), Graybug (C), Kodiak (R), Kodiak (C), Novartis (C), Novartis (S), Novartis (R), Regenxbio (R), Regenxbio (C)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 4222. doi:
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      Jordyn Vannavong, Jonathan Dang, Micaela M. Koci, Aamir Aziz, Fawwaz Siddiqui, Sylvia Phillips, Phoebe Shappell, Molly Hagen, Wei Yang, Jay Chhablani, Arshad M. Khanani; Efficacy of the Treat-and-Extend Regimen in the Management of Neovascular Age-related Macular Degeneration: 6-year Results of the RENO Study. Invest. Ophthalmol. Vis. Sci. 2020;61(7):4222.

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

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Abstract

Purpose : The Treat-and Extend (T&E) method is often used by retina specialists in clinical settings in the treatment of neovascular age-related macular degeneration (nAMD). This study evaluated the outcomes of regular intravitreal ranibizumab, aflibercept, or bevacizumab in patients with nAMD in the United States over the course of six years.

Methods : This is a retrospective, interventional, consecutive case series. 165 eyes from 137 treatment-naïve patients diagnosed with nAMD after August 2010 were treated at a single site by one physician with ranibizumab, aflibercept, or bevacizumab for ≥1 year using a T&E regimen. Patients needed to receive ≥6 injections in the first year and ≥3 injections in the following years to be included in this study. Snellen best-corrected visual acuity (BCVA) was converted to ETDRS letters using a standardized formula. The main outcome measures were: BCVA change from baseline to end of patient follow-up, mean number of injections per year, and percentage of eyes losing ≥15 letters or gaining ≥15 letters.

Results : The average (standard deviation [SD]) baseline patient age was 78 years (8.2); 60% of patients were female. The mean follow-up period was 4.2 years, with 165, 158, 127, 108, 75, and 42 eyes completing 1, 2, 3, 4, 5, and 6 years of follow-up, respectively. The average BCVA at baseline was 53.2 letters. Mean (SD) changes from baseline in BCVA were 8.2 (21.8) letters, 7.0 (25.0) letters, 4.8 (26.9) letters, 4.6 (27.8) letters, 5.7 (27.7) letters, and 0.3 (30.1) letters for years 1, 2, 3, 4, 5, and 6, respectively. The mean number of injections received by patients in year 1 was 8. In years 2 through 6, the mean number of injections received by patients was 6. At the final follow-up, 18.8% of eyes had lost ≥15 letters and 26.1% of eyes had gained ≥15 letters.

Conclusions : The Treat-and-Extend regimen was effective in maintaining visual acuity in patients with nAMD treated with ranibizumab, aflibercept, or bevacizumab for up to 6 years in patients who received a minimum of 6 injections in the first year and a minimum of 3 injections in the follow up years 2 through 6. The initial vision gains seen in the first 5 years of follow-up were not maintained at year 6.

This is a 2020 ARVO Annual Meeting abstract.

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