The Effects of Treatment Regimen on the Initial Management of Macular Neovascularization Subtypes in Age-Related Macular Degeneration.

Abstract

INTRODUCTION:

The aim of this study was to evaluate the effect of initial treatment regimen individualization (pro re nata or treat-and-extend [TAE]), according to macular neovascularization (MNV) subtype, on the functional and anatomical response in neovascular age-related macular degeneration (nAMD). The secondary objective was to compare the treatment burden between each MNV subtype.

METHODS:

Consecutive treatment-naïve nAMD patients were retrospectively included. MNV subtype was graded by 2 independent blinded investigators on multimodal imaging. Functional and anatomical outcomes were analysed according to treatment regimen and MNV subtypes.

RESULTS:

A total of 281 eyes from 243 patients were included in the study. According to the treatment regimen, there was no significant difference in best-corrected visual acuity gain within the first 2 years of treatment for type 1 (p = 0.106) and type 3 MNV (p = 0.704). Conversely, there was a significant difference in favour of TAE regimen for type 2 (p = 0.017) and type 4 MNV (p = 0.047). Type 1 MNV had a higher proportion of visits with subretinal fluid (p = 0.0007) but not with intraretinal fluid (p = 0.22). The mean interval between the last 2 injections was significantly shorter for type 1 MNV (p = 0.0045).

CONCLUSION:

The individualization of the initial treatment protocol according to MNV subtype can improve the functional outcome and may decrease the treatment burden.

• Authors: Kenny Kodaday, Laurent Kodjikian, Etienne Gadiollet, Nicolas Chirpaz, Olivier Loria, Audrey Feldman, Flore De Bats, Carole Burillon, Philippe Denis, Pierre Pradat, Thibaud Mathis
• Journal: Ophthalmologica. Journal international d'ophtalmologie. International journal of ophthalmology. Zeitschrift fur Augenheilkunde (Ophthalmologica) Vol. 246 Issue 2 Pg. 113-122 ( 2023) ISSN: 1423-0267 [Electronic] Switzerland
• PMID: 36720212 (Publication Type: Journal Article)
• Copyright: © 2023 S. Karger AG, Basel.

Chemical References

• Angiogenesis Inhibitors
• Ranibizumab

Topics

• Humans
• Angiogenesis Inhibitors (administration & dosage, therapeutic use)
• Follow-Up Studies
• Intravitreal Injections
• Macular Degeneration (drug therapy)
• Ranibizumab (administration & dosage, therapeutic use)
• Retrospective Studies
• Tomography, Optical Coherence
• Treatment Outcome
• Wet Macular Degeneration (diagnosis, drug therapy)