Abstract
Purpose :
To compare the outcomes of neovascular age-related macular degeneration (nvAMD) patients treated with a modified treat and extend protocol (MTAE) to that of those treated with a conventional treat and extend protocol (TAE).
Methods :
A retrospective analysis of two consecutive groups of treatment naive nvAMD patients was conducted. The first group began anti-vascular endothelial growth factor (VEGF) therapy between January 2006 and December 2011, and were treated using the conventional TAE protocol. The second group began anti-VEGF treatment between January 2016 and December 2017 and was treated using a MTAE. In the MTAE protocol, visual acuity and dilated fundus exams were performed once in 3 visits, while during the other 2 visits, an OCT assessment was used to guide retreatment. The time spent per encounter, and the visual and anatomical outcomes were compared between the two groups after 36 months of follow-up.
Results :
The TAE and MTAE cohorts included 135 eyes (116 patients, 41.4% female, mean age: 76.9±7.8 years) and 119 eyes (94 patients, 55.3% female, mean age 79.8±6.8 years), respectively. Both groups had similar baseline characteristics. At 36 months, the number of injections administered, (7.9±2.9 vs 8.1±2.3 injections, respectively, p=0.55), the number of eyes that gained ≥15 Early Treatment for Diabetic Retinopathy Study (ETDRS) letters 31 (23%) vs 30 (25.2%), respectively (p=0.39) and lost ≥15 EDTRS letters 29 (21.5%) vs 21 (17.7%), respectively, were similar in both groups (p=0.43). Anatomical outcomes per OCT were also similar in both groups. Both waiting time and service time were reduced during OCT-only assessments compared to full assessments (32±20 minutes vs 56±40 minutes, and 9±4 minutes vs 26±10 minutes, respectively, p<0.001 in each case). Saving an average of 41 minutes for each patient encounter.
Conclusions :
MTAE and TAE protocols yielded comparable visual and anatomical outcomes. Applying MTAE leads to reduced number of full assessment visits which is associated with shorter time spent in the clinic during the OCT-only assessment visits. MTAE may further streamline anti-VEGF therapy, thereby, reducing patient, caregivers, and staff time allocated to treatment.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.