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Two-Year Outcomes of “Treat and Extend” Intravitreal Therapy for Neovascular Age-Related Macular Degeneration

Arnold, Jennifer J., MB BS (Hons) ; Campain, Anna, PhD ; Barthelmes, Daniel, MD, PhD ; Simpson, Judy M., PhD, CStat ; Guymer, Robyn H., MB BS, PhD ; Hunyor, Alex P., MB BS ; McAllister, Ian L., MB BS ; Essex, Rohan W., MB BS ; Morlet, Nigel, MB BS ; Gillies, Mark C., MB BS, PhD

Ophthalmology (Rochester, Minn.), 2015-06, Vol.122 (6), p.1212-1219 [Peer Reviewed Journal]

United States: Elsevier Inc

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Title:
Two-Year Outcomes of “Treat and Extend” Intravitreal Therapy for Neovascular Age-Related Macular Degeneration
Author: Arnold, Jennifer J., MB BS (Hons) ; Campain, Anna, PhD ; Barthelmes, Daniel, MD, PhD ; Simpson, Judy M., PhD, CStat ; Guymer, Robyn H., MB BS, PhD ; Hunyor, Alex P., MB BS ; McAllister, Ian L., MB BS ; Essex, Rohan W., MB BS ; Morlet, Nigel, MB BS ; Gillies, Mark C., MB BS, PhD
Subjects: Aged ; Aged, 80 and over ; Angiogenesis Inhibitors - therapeutic use ; Antibodies, Monoclonal, Humanized - therapeutic use ; Bevacizumab ; Female ; Follow-Up Studies ; Humans ; Intravitreal Injections ; Male ; Ophthalmology ; Ranibizumab ; Receptors, Vascular Endothelial Growth Factor - therapeutic use ; Recombinant Fusion Proteins - therapeutic use ; Registries ; Treatment Outcome ; Vascular Endothelial Growth Factor A - antagonists & inhibitors ; Visual Acuity - physiology ; Wet Macular Degeneration - diagnosis ; Wet Macular Degeneration - drug therapy ; Wet Macular Degeneration - physiopathology
Is Part Of: Ophthalmology (Rochester, Minn.), 2015-06, Vol.122 (6), p.1212-1219
Notes: ObjectType-Article-1
SourceType-Scholarly Journals-1
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ObjectType-Undefined-2
Description: Purpose To report 24-month outcomes of anti-vascular endothelial growth factor (VEGF) therapy for treatment-naïve eyes with neovascular age-related macular degeneration (nAMD) using a treat and extend treatment regimen in routine clinical practice. Design Database observational study. Participants We included treatment-naïve eyes receiving predominantly ranibizumab for nAMD in routine clinical practice treated using a treat and extend regimen that were tracked in the Fight Retinal Blindness observational registry. Methods A cohort of eyes treated by practitioners using exclusively a treat and extend regimen was extracted from the Fight Retinal Blindness observational registry. Main Outcome Measures Change in visual acuity (VA) over 2 years and number of injections and visits. Results Data from 1198 eyes from 1011 patients receiving anti-VEGF therapy using a treat and extend regimen for treatment-naïve nAMD between January 2007 and December 2012 and with 24-month follow-up were included in the analysis. Mean VA increased by +5.3 logarithm of the minimum angle of resolution letters from 56.5 letters (20/80+1) at initial visit to 61.8 (20/60+2) letters at 24 months. Mean VA gains improved and number of injections increased with successive years from +2.7 letters for eyes commencing in 2007 after a mean of 9.7 injections in 2 years, to +7.8 letters for eyes commencing in 2012 after a mean of 14.2 injections over 2 years. The proportion of eyes with VA >20/40 increased from 27% when starting treatment to 45% after 24 months; the proportion with vision of <20/200 remained unchanged (13% initial, 11% at 24 months). Of the included eyes, 90.5% avoided a vision loss of ≥15 letters. There was an overall mean of 13.0 injections over the 24 months, 7.5 injections in the first year and 5.5 in the second year, with a mean of 14.8 clinic visits. Conclusions These data indicate that eyes managed in routine clinical practice with a treat and extend regimen can achieve good visual outcomes while decreasing the burden of treatments and clinic visits.
Publisher: United States: Elsevier Inc
Language: English

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Two-Year Outcomes of “Treat and Extend” Intravitreal Therapy for Neovascular Age-Related Macular Degeneration

Arnold, Jennifer J., MB BS (Hons) ; Campain, Anna, PhD ; Barthelmes, Daniel, MD, PhD ; Simpson, Judy M., PhD, CStat ; Guymer, Robyn H., MB BS, PhD ; Hunyor, Alex P., MB BS ; McAllister, Ian L., MB BS ; Essex, Rohan W., MB BS ; Morlet, Nigel, MB BS ; Gillies, Mark C., MB BS, PhD

United States: Elsevier Inc

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