Intravitreal aflibercept following treat and extend protocol versus fixed protocol for treatment of neovascular age-related macular degeneration
Abstract Background To assess the morphological and functional outcome of intravitreal aflibercept following the treat and extend protocol compared to the fixed protocol for treatment of eyes with neovascular age-related macular degeneration. Methods This retrospective study included 126 eyes of 113...
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| Format: | Article |
| Language: | English |
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BMC
2021-12-01
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| Series: | International Journal of Retina and Vitreous |
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| Online Access: | https://doi.org/10.1186/s40942-021-00349-x |
| _version_ | 1818383898919305216 |
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| author | Alaa Din Abdin Asem Mohamed Cristian Munteanu Isabel Weinstein Achim Langenbucher Berthold Seitz Shady Suffo |
| author_facet | Alaa Din Abdin Asem Mohamed Cristian Munteanu Isabel Weinstein Achim Langenbucher Berthold Seitz Shady Suffo |
| author_sort | Alaa Din Abdin |
| collection | DOAJ |
| description | Abstract Background To assess the morphological and functional outcome of intravitreal aflibercept following the treat and extend protocol compared to the fixed protocol for treatment of eyes with neovascular age-related macular degeneration. Methods This retrospective study included 126 eyes of 113 patients with primary onset neovascular age-related macular degeneration who were followed for 12 months. All eyes were treated with 2 mg/0.05 mL aflibercept. All eyes received an upload with three monthly aflibercept injections. We subsequently studied two groups of eyes. For group 1, 54 eyes were treated following the treat and extend protocol. For group 2, 72 eyes were treated following the fixed protocol (fixed 2-monthly interval). Main outcome measures included: best corrected visual acuity (BCVA), central macular thickness (CMT) and number of injections. Results BCVA (logMAR) in group 1 vs group 2 was (0.61 ± 0.3 vs 0.72 ± 0.3, p = 0.09) before treatment and (0.48 ± 0.3 vs 0.51 ± 0.3, p = 0.6) after one year of treatment. CMT in group 1 vs group 2 was (371 ± 101 μm vs 393 ± 116 μm, p = 0.5) before treatment and (284 ± 60 μm vs 290 ± 67 μm, p = 0.1) after one year of treatment. Number of injections/eye in group 1 vs group 2 was (8.5 ± 2.2 vs 7.0 ± 0, p < 0.001). Conclusions Significant differences regarding BCVA and central macular thickness were not found between both treatment protocols during the first year of treatment using aflibercept. However, a significantly higher number of injections was needed for eyes in the treat and extend group during the first year of treatment. This might suggest that aflibercept should better not be extended past an 8 weeks interval during the first year of treatment. Study registration This study was approved by the Ethics Committee of the Medical Association of Saarland, Germany (Nr. 123/20, Date: 16.06.2020). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors. |
| first_indexed | 2024-12-14T03:13:41Z |
| format | Article |
| id | doaj.art-1ccbc6b2eec24693ae403189a67f1831 |
| institution | Directory Open Access Journal |
| issn | 2056-9920 |
| language | English |
| last_indexed | 2024-12-14T03:13:41Z |
| publishDate | 2021-12-01 |
| publisher | BMC |
| record_format | Article |
| series | International Journal of Retina and Vitreous |
| spelling | doaj.art-1ccbc6b2eec24693ae403189a67f18312022-12-21T23:19:12ZengBMCInternational Journal of Retina and Vitreous2056-99202021-12-01711510.1186/s40942-021-00349-xIntravitreal aflibercept following treat and extend protocol versus fixed protocol for treatment of neovascular age-related macular degenerationAlaa Din Abdin0Asem Mohamed1Cristian Munteanu2Isabel Weinstein3Achim Langenbucher4Berthold Seitz5Shady Suffo6Department of Ophthalmology, Saarland University Medical Center UKSDepartment of Ophthalmology, Westpfalz HospitalDepartment of Ophthalmology, Saarland University Medical Center UKSDepartment of Ophthalmology, Saarland University Medical Center UKSInstitute of Experimental Ophthalmology, Saarland UniversityDepartment of Ophthalmology, Saarland University Medical Center UKSDepartment of Ophthalmology, Saarland University Medical Center UKSAbstract Background To assess the morphological and functional outcome of intravitreal aflibercept following the treat and extend protocol compared to the fixed protocol for treatment of eyes with neovascular age-related macular degeneration. Methods This retrospective study included 126 eyes of 113 patients with primary onset neovascular age-related macular degeneration who were followed for 12 months. All eyes were treated with 2 mg/0.05 mL aflibercept. All eyes received an upload with three monthly aflibercept injections. We subsequently studied two groups of eyes. For group 1, 54 eyes were treated following the treat and extend protocol. For group 2, 72 eyes were treated following the fixed protocol (fixed 2-monthly interval). Main outcome measures included: best corrected visual acuity (BCVA), central macular thickness (CMT) and number of injections. Results BCVA (logMAR) in group 1 vs group 2 was (0.61 ± 0.3 vs 0.72 ± 0.3, p = 0.09) before treatment and (0.48 ± 0.3 vs 0.51 ± 0.3, p = 0.6) after one year of treatment. CMT in group 1 vs group 2 was (371 ± 101 μm vs 393 ± 116 μm, p = 0.5) before treatment and (284 ± 60 μm vs 290 ± 67 μm, p = 0.1) after one year of treatment. Number of injections/eye in group 1 vs group 2 was (8.5 ± 2.2 vs 7.0 ± 0, p < 0.001). Conclusions Significant differences regarding BCVA and central macular thickness were not found between both treatment protocols during the first year of treatment using aflibercept. However, a significantly higher number of injections was needed for eyes in the treat and extend group during the first year of treatment. This might suggest that aflibercept should better not be extended past an 8 weeks interval during the first year of treatment. Study registration This study was approved by the Ethics Committee of the Medical Association of Saarland, Germany (Nr. 123/20, Date: 16.06.2020). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.https://doi.org/10.1186/s40942-021-00349-xNeovascular age-related macular degenerationAfliberceptTreat and extendFixed protocol |
| spellingShingle | Alaa Din Abdin Asem Mohamed Cristian Munteanu Isabel Weinstein Achim Langenbucher Berthold Seitz Shady Suffo Intravitreal aflibercept following treat and extend protocol versus fixed protocol for treatment of neovascular age-related macular degeneration International Journal of Retina and Vitreous Neovascular age-related macular degeneration Aflibercept Treat and extend Fixed protocol |
| title | Intravitreal aflibercept following treat and extend protocol versus fixed protocol for treatment of neovascular age-related macular degeneration |
| title_full | Intravitreal aflibercept following treat and extend protocol versus fixed protocol for treatment of neovascular age-related macular degeneration |
| title_fullStr | Intravitreal aflibercept following treat and extend protocol versus fixed protocol for treatment of neovascular age-related macular degeneration |
| title_full_unstemmed | Intravitreal aflibercept following treat and extend protocol versus fixed protocol for treatment of neovascular age-related macular degeneration |
| title_short | Intravitreal aflibercept following treat and extend protocol versus fixed protocol for treatment of neovascular age-related macular degeneration |
| title_sort | intravitreal aflibercept following treat and extend protocol versus fixed protocol for treatment of neovascular age related macular degeneration |
| topic | Neovascular age-related macular degeneration Aflibercept Treat and extend Fixed protocol |
| url | https://doi.org/10.1186/s40942-021-00349-x |
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