Better visual outcome at 1 year with antivascular endothelial growth factor treatment according to treat-and-extend compared with pro re nata in eyes with neovascular age-related macular degeneration.

Abstract

PURPOSE:

To evaluate treatment outcome at 12 months in eyes with neovascular age-related macular degeneration (nAMD) treated with antivascular endothelial growth factor (anti-VEGF) injections according to either pro re nata (PRN)- or treat-and-extend (TE)-regimen in one clinical setting in Sweden.

METHODS:

Data were obtained retrospectively from the Swedish Macula Register, optical coherence tomography-database and electronic patient charts. The study included 443 eyes; 223 PRN- and 220 TE-treated eyes. Baseline (BL) characteristics and follow-up data at 6 and 12 months were collected. Statistical regression analysis was performed to evaluate association between treatment strategy and visual outcome at 12 months.

RESULTS:

Baseline (BL) characteristics were well balanced between cohorts. Visual acuity at 12 months was higher in TE-cohort 66.5 (13.1) compared to PRN-cohort 60.1 (17.6) (p = 0.000). Visual improvement at 12 months was +5.2 (11.8) and +1.2 (12.7) letters Early Treatment Diabetic Retinopathy Study (ETDRS) in TE- and PRN-cohorts, respectively (p = 0.002). Number of administered injections at 12 months was 10.2 (2.1) and 6.3 (2.1) in the two cohorts (p = 0.000). Statistical analysis demonstrated a strong association between TE treatment strategy and improvement in visual acuity at 12 months.

CONCLUSION:

Eyes treated according to TE had better visual outcome at 12 months. The results indicate that treatment according to proactive TE-regimen is superior to treatment according to PRN-regimen in clinical routine care of nAMD.

• Authors: Sandra Aurell, Kersti Sjövall, Anna Paul, Åsa Morén, Elisabet Granstam
• Journal: Acta ophthalmologica (Acta Ophthalmol) Vol. 97 Issue 5 Pg. 519-524 (Aug 2019) ISSN: 1755-3768 [Electronic] England
• PMID: 30511374 (Publication Type: Comparative Study, Journal Article)
• Copyright: © 2018 The Authors. Acta Ophthalmologica published by John Wiley & Sons Ltd on behalf of Acta Ophthalmologica Scandinavica Foundation.

Chemical References

• Angiogenesis Inhibitors
• Recombinant Fusion Proteins
• aflibercept
• Receptors, Vascular Endothelial Growth Factor
• Ranibizumab

Topics

• Aged
• Angiogenesis Inhibitors (administration & dosage)
• Dose-Response Relationship, Drug
• Female
• Follow-Up Studies
• Humans
• Intravitreal Injections
• Macula Lutea (pathology)
• Male
• Ranibizumab (administration & dosage)
• Receptors, Vascular Endothelial Growth Factor (administration & dosage, antagonists & inhibitors)
• Recombinant Fusion Proteins (administration & dosage)
• Retrospective Studies
• Time Factors
• Tomography, Optical Coherence (methods)
• Treatment Outcome
• Visual Acuity
• Wet Macular Degeneration (diagnosis, drug therapy, physiopathology)