Treat-And-extend bevacizumab for neovascular age-related macular degeneration: The importance of baseline characteristics
PURPOSE:: To evaluate the factors affecting visual and anatomical outcomes and the number of intravitreal bevacizumab injections required in the treatment of neovascular age-related macular degeneration using a treat-And-extend regimen. METHODS:: Retrospective consecutive case series. The charts of...
| Main Authors: | , , , , |
|---|---|
| Format: | Journal article |
| Language: | English |
| Published: |
Lippincott Williams and Wilkins
2014
|
| _version_ | 1826271241501147136 |
|---|---|
| author | Rush, R Simunovic, M Vandiver, L Aragon, A Ysasaga, J |
| author_facet | Rush, R Simunovic, M Vandiver, L Aragon, A Ysasaga, J |
| author_sort | Rush, R |
| collection | OXFORD |
| description | PURPOSE:: To evaluate the factors affecting visual and anatomical outcomes and the number of intravitreal bevacizumab injections required in the treatment of neovascular age-related macular degeneration using a treat-And-extend regimen. METHODS:: Retrospective consecutive case series. The charts of subjects treated with intravitreal bevacizumab for neovascular age-related macular degeneration using a treat-And-extend regimen over a 12-month period were reviewed. The key variables explored were patient age, phakic status, posterior vitreous detachment status, baseline best-corrected visual acuity (BCVA), baseline central macular thickness (CMT), and type of chorodial neovascularization. The primary outcome measures were improvement in BCVA of 3 logMAR lines or more, maintenance of BCVA within 3 logMAR lines of baseline, number of intravitreal injections delivered over a 12-month period, and final CMT on optical coherence tomography. RESULTS:: A total of 230 eyes met the criteria. Mean presenting BCVA was Snellen 20/55 (0.44 logMAR) and mean final BCVA was Snellen 20/44 (0.35 logMAR) (P < 0.001). A total of 23.5% (95% confidence interval [CI], 18.5-29.4%) of the subjects demonstrated an improvement in BCVA of 3 or more logMAR lines, whereas 96.5% (95% CI, 93.3-98.2%) of the subjects lost fewer than 3 logMAR lines. Mean CMT on optical coherence tomography changed from a baseline average of 373.1 μm (95%CI, 360.3-386.1 μm) to a final average of 305.5 μm (95% CI, 290.0-316.0 μm). The average number of injections during the 12-month period was 9.2 (95% CI, 9.0-9.4). Posterior vitreous detachment was associated with fewer injections on univariate and multivariate analysis (8.7 injections in the posterior vitreous detachment group versus 9.8 in the non-posterior vitreous detachment group, P < 0.001). Patients with poorer presenting BCVA and greater baseline CMTs were more likely to demonstrate a 3 or more logMAR line improvement in BCVA. Thinner final CMTs were independently associated with thinner presenting CMTs and fewer injections. CONCLUSION:: Favorable visual and anatomical outcomes may be achieved with intravitreal bevacizumab in the treatment of neovascular age-related macular degeneration using a treat-And-extend regimen. Our study suggests that posterior vitreous detachment may play a role in the efficacy of intravitreal bevacizumab during the treatment of neovascular age-related macular degeneration. © by Opthamic Communication Society, Inc. Unauthorized reproduction of this article is prohibited. |
| first_indexed | 2024-03-06T21:53:33Z |
| format | Journal article |
| id | oxford-uuid:4c236ea3-e9cf-4e57-8cad-589bcd3fdd3e |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T21:53:33Z |
| publishDate | 2014 |
| publisher | Lippincott Williams and Wilkins |
| record_format | dspace |
| spelling | oxford-uuid:4c236ea3-e9cf-4e57-8cad-589bcd3fdd3e2022-03-26T15:47:41ZTreat-And-extend bevacizumab for neovascular age-related macular degeneration: The importance of baseline characteristicsJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:4c236ea3-e9cf-4e57-8cad-589bcd3fdd3eEnglishSymplectic Elements at OxfordLippincott Williams and Wilkins2014Rush, RSimunovic, MVandiver, LAragon, AYsasaga, JPURPOSE:: To evaluate the factors affecting visual and anatomical outcomes and the number of intravitreal bevacizumab injections required in the treatment of neovascular age-related macular degeneration using a treat-And-extend regimen. METHODS:: Retrospective consecutive case series. The charts of subjects treated with intravitreal bevacizumab for neovascular age-related macular degeneration using a treat-And-extend regimen over a 12-month period were reviewed. The key variables explored were patient age, phakic status, posterior vitreous detachment status, baseline best-corrected visual acuity (BCVA), baseline central macular thickness (CMT), and type of chorodial neovascularization. The primary outcome measures were improvement in BCVA of 3 logMAR lines or more, maintenance of BCVA within 3 logMAR lines of baseline, number of intravitreal injections delivered over a 12-month period, and final CMT on optical coherence tomography. RESULTS:: A total of 230 eyes met the criteria. Mean presenting BCVA was Snellen 20/55 (0.44 logMAR) and mean final BCVA was Snellen 20/44 (0.35 logMAR) (P < 0.001). A total of 23.5% (95% confidence interval [CI], 18.5-29.4%) of the subjects demonstrated an improvement in BCVA of 3 or more logMAR lines, whereas 96.5% (95% CI, 93.3-98.2%) of the subjects lost fewer than 3 logMAR lines. Mean CMT on optical coherence tomography changed from a baseline average of 373.1 μm (95%CI, 360.3-386.1 μm) to a final average of 305.5 μm (95% CI, 290.0-316.0 μm). The average number of injections during the 12-month period was 9.2 (95% CI, 9.0-9.4). Posterior vitreous detachment was associated with fewer injections on univariate and multivariate analysis (8.7 injections in the posterior vitreous detachment group versus 9.8 in the non-posterior vitreous detachment group, P < 0.001). Patients with poorer presenting BCVA and greater baseline CMTs were more likely to demonstrate a 3 or more logMAR line improvement in BCVA. Thinner final CMTs were independently associated with thinner presenting CMTs and fewer injections. CONCLUSION:: Favorable visual and anatomical outcomes may be achieved with intravitreal bevacizumab in the treatment of neovascular age-related macular degeneration using a treat-And-extend regimen. Our study suggests that posterior vitreous detachment may play a role in the efficacy of intravitreal bevacizumab during the treatment of neovascular age-related macular degeneration. © by Opthamic Communication Society, Inc. Unauthorized reproduction of this article is prohibited. |
| spellingShingle | Rush, R Simunovic, M Vandiver, L Aragon, A Ysasaga, J Treat-And-extend bevacizumab for neovascular age-related macular degeneration: The importance of baseline characteristics |
| title | Treat-And-extend bevacizumab for neovascular age-related macular degeneration: The importance of baseline characteristics |
| title_full | Treat-And-extend bevacizumab for neovascular age-related macular degeneration: The importance of baseline characteristics |
| title_fullStr | Treat-And-extend bevacizumab for neovascular age-related macular degeneration: The importance of baseline characteristics |
| title_full_unstemmed | Treat-And-extend bevacizumab for neovascular age-related macular degeneration: The importance of baseline characteristics |
| title_short | Treat-And-extend bevacizumab for neovascular age-related macular degeneration: The importance of baseline characteristics |
| title_sort | treat and extend bevacizumab for neovascular age related macular degeneration the importance of baseline characteristics |
| work_keys_str_mv | AT rushr treatandextendbevacizumabforneovascularagerelatedmaculardegenerationtheimportanceofbaselinecharacteristics AT simunovicm treatandextendbevacizumabforneovascularagerelatedmaculardegenerationtheimportanceofbaselinecharacteristics AT vandiverl treatandextendbevacizumabforneovascularagerelatedmaculardegenerationtheimportanceofbaselinecharacteristics AT aragona treatandextendbevacizumabforneovascularagerelatedmaculardegenerationtheimportanceofbaselinecharacteristics AT ysasagaj treatandextendbevacizumabforneovascularagerelatedmaculardegenerationtheimportanceofbaselinecharacteristics |