Treatment Outcomes After 3 Years in Neovascular Age-Related Macular Degeneration Using a Treat-and-Extend Regimen

• Published in: American journal of ophthalmology Vol. 159; no. 1; pp. 3 - 8.e1
• Main Authors: Rayess, Nadim, Houston, S.K. Steven, Gupta, Omesh P., Ho, Allen C., Regillo, Carl D.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.01.2015; Elsevier Limited
• Subjects: Aged; Aged, 80 and over; Algorithms; Angiogenesis Inhibitors - therapeutic use; Antibodies, Monoclonal, Humanized - therapeutic use; Bevacizumab; Choroidal Neovascularization - drug therapy; Clinical outcomes; Diabetes; Diabetic retinopathy; Female; Follow-Up Studies; Humans; Macular degeneration; Macular Degeneration - drug therapy; Male; Ophthalmology; Outcome Assessment (Health Care); Patients; Ranibizumab; Retrospective Studies; Standard deviation; Statistical analysis; Studies; Tomography; Tomography, Optical Coherence; Visual Acuity; California
• ISSN: 0002-9394; 1879-1891; 1879-1891
• DOI: 10.1016/j.ajo.2014.09.011

To determine 3-year treatment outcomes after 1 to 3 years of ranibizumab or bevacizumab therapy using a treat-and-extend regimen in patients with neovascular age-related macular degeneration (AMD). Retrospective, interventional, consecutive case series. We treated 212 eyes from 196 patients diagnosed with treatment-naive neovascular AMD between January 2009 and March 2013; they were treated with either ranibizumab or bevacizumab for a minimum of 1 year, using a treat-and-extend regimen. The main outcome measures were change from baseline best-corrected Snellen visual acuity (BCVA), proportion of eyes losing <3 BCVA lines, proportion of eyes gaining ≥3 BCVA lines, change from baseline central retinal thickness, and mean number of injections at 1, 2 and 3 years of follow-up. The mean follow-up period was 1.88 years (median, 2 years). At baseline, mean BCVA was 20/139; it improved to 20/79 (P < 0.001) after 1 year of treatment and was maintained at 20/69 and 20/64 at 2 and 3 years follow-up (P < 0.001), respectively. At baseline, mean central retinal thickness was 351 μm and significantly decreased to 285 μm, 275 μm and 276 μm at 1, 2 and 3 years of follow-up (P < 0.001), respectively. Patients received, on average, 7.6, 5.7 and 5.8 injections over years 1, 2 and 3 of treatment, respectively. At final follow-up, 94% of eyes had lost <3 lines BCVA, and 34.4% of eyes had gained ≥3 lines BCVA. The treat-and-extend regimen is effective in achieving and maintaining visual and anatomic improvements in patients with neovascular AMD for up to 3 years of treatment.