Real world treatment intervals in eyes with nAMD treated with Aflibercept. Retrospective UK multicentre study.

Abstract

Purpose : To report real world treatment patterns in patients with neovascular age related macular degeneration (nAMD) treated at 19 UK centres.

Methods : Anonymized data of patients treated with Aflibercept anti-VEGF injections for nAMD between 01/04/2018 and 31/10/2023 at 19 UK centres was extracted from Medisoft and MediSIGHT.
Eligible were eyes which have finished loading phase and had at least 4 injections after completing 1st and/or 2nd year (yr) of treatment.
Visual acuity (VA) change was assessed at 1 and 2 yrs after starting treatment. Injection intervals were based on time between first 4 injections after conclusion of 1st and 2nd yr of treatment.

Results : The calculations for yr 1 were performed for 19,565 eyes (16,418 patients) treated with 130,086 injections. After finishing yr 1 of treatment, 29.4% of eyes with 95% CI (28.7%,30.0%) continued with injection intervals of 12 weeks or more. 21.0% eyes followed ≤ 8 week, 33.2% 8-12 week, 18.4% 12-16 week, 1.9% ≥ 16 week and 25.6% mixed interval schedule.
Median number of injections was 7.0 with IQR (5.0,8.0) and ranged between centers 4.0 to 8.0. The median baseline VA was 65.0 ETDRS letters (EL) and VA change over 1st yr of treatment was 0 EL and IQR (-5,10). There was up to 5 EL difference in VA change between centres and 1 EL difference between over and under 12 weeks treatment group.
The calculations for yr 2 were performed for 13,451 eyes (11,429 patients) treated with 153,585 injections. After finishing yr 2, 29.0% of eyes with 95% CI (28.3%,29.8%) continued with injection intervals of 12 or more weeks. 19.2% of eyes followed ≤ 8 week, 36.7% 8-12 week, 18.4% 12-16 week, 2.2% ≥ 16 week and 23.6% mixed interval schedule.
Median number of injections was 11.0 with IQR (9.0,14.0) and ranged between centers 6.0 to 14.0. The median baseline VA was 65.0 EL and median VA change over 1st two yrs of treatment was 0 EL and IQR (-6,9). There was up to 7 EL difference in median VA change between centres and no difference between over and under 12 weeks treatment groups.

Conclusions : 29.4% of eyes after finishing 1st yr and 29.0% of eyes after finishing 2nd yr of anti-VEGF treatment continued with injection intervals of 12 weeks or more.
Eyes had good vision at treatment commencement and Aflibercept treatment was effective at maintaining vision in patients with nAMD including eyes where treatment intervals were extended to above 12 weeks.

This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.