June 2021
Volume 62, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2021
Efficacy and outcome predictors of long-term intravitreal anti-VEGF therapy in neovascular age-related macular degeneration following a strict treat-and-extend regimen.
Author Affiliations & Notes
  • Katja B Hatz
    Vista Klinik AG, Binningen, Switzerland
    Universitat Basel Medizinische Fakultat, Basel, BS, Switzerland
  • Footnotes
    Commercial Relationships   Katja Hatz, Allergan (F), Bayer Switzerland (F), Novartis Switzerland (F), Roche (F)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2021, Vol.62, 438. doi:
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      Katja B Hatz; Efficacy and outcome predictors of long-term intravitreal anti-VEGF therapy in neovascular age-related macular degeneration following a strict treat-and-extend regimen.. Invest. Ophthalmol. Vis. Sci. 2021;62(8):438.

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

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Abstract

Purpose : To determine functional and morphological long-term outcomes and outcome predicting factors in patients with neovascular age-related macular degeneration (nAMD) applying a treat-and-extend regimen (TER).

Methods : Consecutive retrospective case series of treatment-naïve subjects with nAMD starting treatment with either ranibizumab or aflibercept in a strict TER without loading dose and exit strategy.

Results : Two hundred-eleven (211) eyes of 187 patients with a mean follow-up of 60.3±20.9 months were included. Mean BCVA increased from initially 63.9±15.5 ETDRS letters (20/55) to 70.0±14.7 (20/40) after one year (+6.1 letters, p<0.001) and to 68.5±18.1 (20/43) (+4.6 letters, p=0.028) at 5 years. Mean number of injections decreased from 9.9±2.1 during the first year to 7.54±3.6 (p<0.001) at year 5. During follow-up 30.3% of eyes reached exit criteria. Significant predictors of BCVA gain at 5 years were a worse baseline BCVA (p=0.001), a better external limiting membrane (ELM) disruption score (p=0.019) and the absence of central geographic atrophy at diagnosis (p=0.006). The probability of reaching the exit criteria was significantly predicted by a low central retinal thickness (CRT) (p=0.025), a better ELM disruption score at baseline (p=0.044) and the absence of a central pigment epithelial detachment (PED) (p=0.05).

Conclusions : Significant visual gains were sustained after 5 years of follow-up in a TER in a real-world setting. Integrity of ELM at baseline was associated with BCVA gain and anatomic disease stability at 5 years of treatment.

This is a 2021 ARVO Annual Meeting abstract.

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