Five-year outcomes of intravitreal drug therapy for neovascular age-related macular degeneration in eyes with baseline vision 20/60 or better

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Khanani, Arshad M.
Gahn, Greggory M.
Koci, Micaela M.
Dang, Jonathan M.
Brown, Sandra M.
Hill, Lauren F.

Issue Date

2019

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Article

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neovascular age-related macular degeneration , ranibizumab , aflibercept , bevacizumab , treat and extend protocol , visual acuity

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Abstract

To assess outcomes in treatment-naive eyes with neovascular age-related macular degeneration (nAMD) and good baseline visual acuity (VA) treated using a treat-and-extend (T&E) regimen with intravitreal aflibercept, ranibizumab, or bevacizumab. Design: Single center, retrospective, observational case series. Participants: Ninety-one patients (93 eyes) with nAMD and baseline VA >= 20/60 followed for >= 1 year after the first intravitreal injection. Minimum of 6 (first year) and 3 (subsequent years) and maximum of 12 injections per 12 calendar months. Intervention: Intravitreal aflibercept 2.0 mg, ranibizumab 0.5 mg, or bevacizumab 1.25 mg. Three monthly injections. Treatment interval extended in 2-week increments after resolution of macular edema and reduced in 2-week increments if edema recurred
maximum interval of 12 weeks. Medication changed if edema recurred during and persisted after three monthly injections of original agent. Main outcome measures: VA maintenance over time. Total number of injections received by year of treatment. Results: Ninety-three eyes were analyzed. Pretreatment VA was 20/20-20/25 (N=16), 20/30-20/40 (N=47), and 20/50-20/60 (N=30). Mean follow-up was 3.2 years. Follow-up by year was 93, 73, 65, 44, and 26 eyes for years 1-5, respectively. Mean number of injections during years 1-5 was 7.9, 5.9, 5.6, 5.9, and 6.0, respectively
mode number of injections was 7, 5, 3, 6, and 4, respectively. For years 1-5, percent of all eyes at or above baseline was 70%, 66%, 65%, 59%, and 58%, respectively
percent >= 20/60 was 86%, 88%, 86%, 84%, and 77% for years 1-5. For eyes with baseline VA >20/40, percent of eyes at or above baseline was 83%, 82%, 81%, 68% and 76% for years 1-5, respectively. Conclusion: Using a T&E intravitreal injection protocol, more than 75% of treatment-naive eyes with nAMD and baseline VA >= 20/60 can maintain VA >= 20/60 over 5 years.

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Khanani, A. M., Gahn, G. M., Koci, M. M., Dang, J. M., Brown, S. M., & Hill, L. F. (2019). <p>Five-year outcomes of intravitreal drug therapy for neovascular age-related macular degeneration in eyes with baseline vision 20/60 or better</p>. Clinical Ophthalmology, Volume 13, 347�"351. doi:10.2147/opth.s191170

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Creative Commons Attribution-NonCommercial 3.0 Unported

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1177-5483

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