Abstract
Purpose :
To evaluate if discontinuation of antiVEGF treatment in wet age related macular degeneration (wAMD) after following a treat and extend regimen (T&E) up to 12 weeks has a detrimental effect on the course of the disease as measured by changes in best corrected visual acuity (BCVA)
Methods :
Retrospective analysis of patient records. 635 eyes treated with either aflibercept or ranibizumab for wAMD in a strict treat & extend (T&E) regimen have been evaluated. After an initial upload, treatment intervals have been prolonged up to a maximum of 12 weeks when signs of activity were absent. Thereafter treatment was paused and regular OCT controls were performed (observation period). Here we evaluate changes in BCVA (calculated as letter score) between consecutive injection visits during T&E to BCVA of consecutive visits during observation period.
Results :
Changes in BCVA showed a significant difference between the T&E and the observation group (p = 0.017). While during the T&E period an overall positive change in letter score was preserved between consecutive visits (mean letter score difference between visits: 0.52), a loss of visual acuity was observed when released into observation only (mean letter score difference between visits: -0,55). 43% of eyes in the observation group required re-IVOM at a mean of 192 days after the last IVOM. However, BCVA at the time of re-IVOM was not significantly lower than at the time when IVOM was paused.
Conclusions :
Discontinuation of antiVEGF therapy in wAMD after reaching a 12 week interval coincides with an increased risk for vision loss. However, with continued monitoring it seems possible to prevent significant vision loss by administering reIVOM as needed. A mean free interval without injections of about half a year is the benefit, for the price of close monitoring.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.