Long-term Outcomes of Treat and Extend Regimen of Anti-vascular Endothelial Growth Factor in Neovascular Age-related Macular Degeneration
Purpose: This study describes the long-term visual and anatomic outcomes of anti-vascular endothelial growth factor (VEGF) treatment using a treat and extend dosing regimen. Methods: This cross-sectional cohort study consisted of 224 treatment-naïve eyes with neovascular age-related macular de...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Knowledge E
2020-08-01
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| Series: | Journal of Ophthalmic & Vision Research |
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| Online Access: | https://doi.org/10.18502/jovr.v15i3.7452 |
| _version_ | 1811323643282587648 |
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| author | Andy Lee Pooja G Garg Alice T Lyon Rukhsana Mirza Manjot K Gill |
| author_facet | Andy Lee Pooja G Garg Alice T Lyon Rukhsana Mirza Manjot K Gill |
| author_sort | Andy Lee |
| collection | DOAJ |
| description | Purpose: This study describes the long-term visual and anatomic outcomes of anti-vascular endothelial growth factor (VEGF) treatment using a treat and extend dosing regimen.
Methods: This cross-sectional cohort study consisted of 224 treatment-naïve eyes with neovascular age-related macular degeneration (NV-AMD) from 202 patients that were treated with anti-VEGF agents bevacizumab, ranibizumab, and aflibercept using a treat and extend (TAE) regimen by four physician investigators in a large urban referral center from 2008 to 2015. Subjects were evaluated for visual acuity, injection frequency, and optical coherence tomography (OCT).
Results: Over a seven-year follow-up period (mean 3.4 years), an average 20.2
±
14.7 injections were administered with 8.4 injections in the first year and 5.5 injections by the seventh year of remaining eyes undergoing treatment. Visual acuity was 0.70 logMAR (20/100 Snellen) at the first visit and 0.67 logMAR (20/93 Snellen) at the final visit, with 74% of eyes maintaining or gaining more than 2 lines of vision. Long-term, 45.1% of eyes achieved 20/50 or better, while 27.1% were 20/200 or worse. Of the treated patients, 61.2% received monotherapy with no difference in visual acuity outcomes or number of injections between the agents used. OCT analysis showed decreased fluid from initial to final follow-up visit: 70.1–15.6% with sub-retinal fluid (SRF) and 47.3–18.8% with intra-retinal fluid (IRF) with no difference between the agents were used.
Conclusion: This study demonstrates that most patients (74%) improve or maintain visual acuity long-term using a TAE model with a significant portion (45.1%) achieving 20/50 or better visual acuity with sustained treatment. |
| first_indexed | 2024-04-13T13:58:49Z |
| format | Article |
| id | doaj.art-8faff1e1807a4742ab06a77d5f374300 |
| institution | Directory Open Access Journal |
| issn | 2008-322X |
| language | English |
| last_indexed | 2024-04-13T13:58:49Z |
| publishDate | 2020-08-01 |
| publisher | Knowledge E |
| record_format | Article |
| series | Journal of Ophthalmic & Vision Research |
| spelling | doaj.art-8faff1e1807a4742ab06a77d5f3743002022-12-22T02:44:06ZengKnowledge EJournal of Ophthalmic & Vision Research2008-322X2020-08-0115333134010.18502/jovr.v15i3.7452jovr.v15i3.7452Long-term Outcomes of Treat and Extend Regimen of Anti-vascular Endothelial Growth Factor in Neovascular Age-related Macular DegenerationAndy Lee0Pooja G Garg1Alice T Lyon2Rukhsana Mirza3Manjot K Gill4 Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, IL, USAPurpose: This study describes the long-term visual and anatomic outcomes of anti-vascular endothelial growth factor (VEGF) treatment using a treat and extend dosing regimen. Methods: This cross-sectional cohort study consisted of 224 treatment-naïve eyes with neovascular age-related macular degeneration (NV-AMD) from 202 patients that were treated with anti-VEGF agents bevacizumab, ranibizumab, and aflibercept using a treat and extend (TAE) regimen by four physician investigators in a large urban referral center from 2008 to 2015. Subjects were evaluated for visual acuity, injection frequency, and optical coherence tomography (OCT). Results: Over a seven-year follow-up period (mean 3.4 years), an average 20.2 ± 14.7 injections were administered with 8.4 injections in the first year and 5.5 injections by the seventh year of remaining eyes undergoing treatment. Visual acuity was 0.70 logMAR (20/100 Snellen) at the first visit and 0.67 logMAR (20/93 Snellen) at the final visit, with 74% of eyes maintaining or gaining more than 2 lines of vision. Long-term, 45.1% of eyes achieved 20/50 or better, while 27.1% were 20/200 or worse. Of the treated patients, 61.2% received monotherapy with no difference in visual acuity outcomes or number of injections between the agents used. OCT analysis showed decreased fluid from initial to final follow-up visit: 70.1–15.6% with sub-retinal fluid (SRF) and 47.3–18.8% with intra-retinal fluid (IRF) with no difference between the agents were used. Conclusion: This study demonstrates that most patients (74%) improve or maintain visual acuity long-term using a TAE model with a significant portion (45.1%) achieving 20/50 or better visual acuity with sustained treatment.https://doi.org/10.18502/jovr.v15i3.7452age-related macular degeneration (amd)intraocular drugsvisual acuity |
| spellingShingle | Andy Lee Pooja G Garg Alice T Lyon Rukhsana Mirza Manjot K Gill Long-term Outcomes of Treat and Extend Regimen of Anti-vascular Endothelial Growth Factor in Neovascular Age-related Macular Degeneration Journal of Ophthalmic & Vision Research age-related macular degeneration (amd) intraocular drugs visual acuity |
| title | Long-term Outcomes of Treat and Extend Regimen of Anti-vascular Endothelial Growth Factor in Neovascular Age-related Macular Degeneration |
| title_full | Long-term Outcomes of Treat and Extend Regimen of Anti-vascular Endothelial Growth Factor in Neovascular Age-related Macular Degeneration |
| title_fullStr | Long-term Outcomes of Treat and Extend Regimen of Anti-vascular Endothelial Growth Factor in Neovascular Age-related Macular Degeneration |
| title_full_unstemmed | Long-term Outcomes of Treat and Extend Regimen of Anti-vascular Endothelial Growth Factor in Neovascular Age-related Macular Degeneration |
| title_short | Long-term Outcomes of Treat and Extend Regimen of Anti-vascular Endothelial Growth Factor in Neovascular Age-related Macular Degeneration |
| title_sort | long term outcomes of treat and extend regimen of anti vascular endothelial growth factor in neovascular age related macular degeneration |
| topic | age-related macular degeneration (amd) intraocular drugs visual acuity |
| url | https://doi.org/10.18502/jovr.v15i3.7452 |
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