June 2021
Volume 62, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2021
Efficacy of the Treat-and-Extend Regimen in the Management of Neovascular Age-Related Macular Degeneration: 7-Year Results of the RENO Study
Author Affiliations & Notes
  • Cecilia Romero
    Sierra Eye Associates, Reno, Nevada, United States
  • Jordyn Vannavong
    Sierra Eye Associates, Reno, Nevada, United States
  • Jonathan M. Dang
    University of Nevada Reno School of Medicine, Reno, Nevada, United States
  • Aamir A. Aziz
    Sierra Eye Associates, Reno, Nevada, United States
  • Phoebe E Shappell
    University of Southern California, Los Angeles, California, United States
  • Adam Wadsworth
    Sierra Eye Associates, Reno, Nevada, United States
  • Fawwaz Siddiqui
    University of Nevada Reno School of Medicine, Reno, Nevada, United States
  • Micaela Koci
    University of Nevada Reno School of Medicine, Reno, Nevada, United States
  • Greggory M. Gahn
    The University of Arizona Department of Ophthalmology and Vision Science, Tucson, Arizona, United States
  • Nazrul Mojumder
    University of Nevada Reno School of Medicine, Reno, Nevada, United States
  • Molly M. Hagen
    University of Nevada Reno School of Medicine, Reno, Nevada, United States
  • Wei Yang
    University of Nevada Reno Division of Health Sciences, Reno, Nevada, United States
  • Jay Chhablani
    University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States
  • Arshad M. Khanani
    Sierra Eye Associates, Reno, Nevada, United States
  • Footnotes
    Commercial Relationships   Cecilia Romero, None; Jordyn Vannavong, None; Jonathan Dang, None; Aamir Aziz, None; Phoebe Shappell, None; Adam Wadsworth, None; Fawwaz Siddiqui, None; Micaela Koci, None; Greggory Gahn, None; Nazrul Mojumder, None; Molly Hagen, None; Wei Yang, None; Jay Chhablani, Allergan (C), Biogen (C), OD-OS (C); Arshad Khanani, Adverum (F), Adverum (C), Allergan (C), Allergan (S), Chengdu Kanghong (F), Chengdu Kanghong (C), DORC (C), Genentech (F), Genentech (C), Genentech (S), Gyroscope (F), Gyroscope (C), Kodiak (F), Kodiak (C), Novartis (F), Novartis (C), Novartis (S), Regenxbio (F), Regenxbio (C), Roche (F)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2021, Vol.62, 436. doi:
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    • Get Citation

      Cecilia Romero, Jordyn Vannavong, Jonathan M. Dang, Aamir A. Aziz, Phoebe E Shappell, Adam Wadsworth, Fawwaz Siddiqui, Micaela Koci, Greggory M. Gahn, Nazrul Mojumder, Molly M. Hagen, Wei Yang, Jay Chhablani, Arshad M. Khanani; Efficacy of the Treat-and-Extend Regimen in the Management of Neovascular Age-Related Macular Degeneration: 7-Year Results of the RENO Study. Invest. Ophthalmol. Vis. Sci. 2021;62(8):436.

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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, bevacizumab, or brolucizumab in patients with nAMD in the United States over the course of seven 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, bevacizumab, or brolucizumab 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 (8.5); 60% of patients were female. The mean follow-up period was 5 years, with 165, 158, 143, 113, 98, 64 and 32 eyes completing 1, 2, 3, 4, 5, 6, and 7 years of follow up, respectively. The average BCVA at baseline was 53 letters. Mean (SD) changes from baseline in BCVA were 8.2 (21.8) letters, 7.0 (25.0) letters, 4.4 (26.7) letters, 4.2 (27.6) letters, 4.4 (28.7) letters, 4.6 (26.2) letters, and 4.6 (37.0) letters for years 1, 2, 3, 4, 5, 6, and 7 respectively. The mean number of injections received by patients in year 1 was 8. In years 2 through 7, the mean number of injections received by patients was 6. At the final follow-up, 23.4% of male eyes and 25.7% of female eyes had lost ≥15 ETDRS letters and 28.1% of male eyes and 27.7% of female 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, bevacizumab, or brolucizumab for up to 7 years of treatment in patients who received a minimum of 6 injections in the first year and a minimum of 3 injections in follow-up years 2 through 7. To reduce overall treatment burden, the Treat-and-Extend regimen is an effective treatment option for patients.

This is a 2021 ARVO Annual Meeting abstract.

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