Long-term visual outcomes for a treat and extend anti-vascular endothelial growth factor regimen in eyes with neovascular age-related macular degeneration

Sarah Mrejen, Jesse J. Jung, Christine Chen, Samir N. Patel, Roberto Gallego-Pinazo, Nicolas Yannuzzi, Luna Xu, Marcela Marsiglia, Sucharita Boddu, K. Bailey Freund

Research output: Contribution to journalArticlepeer-review

39 Scopus citations

Abstract

With the advent of anti-vascular endothelial growth factor (VEGF) therapy, clinicians are now focused on various treatment strategies to better control neovascular age-related macular degeneration (NVAMD), a leading cause of irreversible blindness. Herein, we retrospectively reviewed consecutive patients with treatment-naïve NVAMD initially classified based on fluorescein angiography (FA) alone or with an anatomic classification utilizing both FA and optical coherence tomography (OCT) and correlated long-term visual outcomes of these patients treated with an anti-VEGF Treat-and-Extend Regimen (TER) with baseline characteristics including neovascular phenotype. Overall, 185 patients (210 eyes) were followed over an average of 3.5 years (range 1–6.6) with a retention rate of 62.9%, and visual acuity significantly improved with a TER that required a mean number of 8.3 (±1.6) (± standard deviation) intravitreal anti-VEGF injections/year (range 4–13). The number of injections and the anatomic classification were independent predictors of visual acuity at 6 months, 1, 2, 3 and 4 years. Patients with Type 1 neovascularization had better visual outcomes and received more injections than the other neovascular subtypes. There were no serious adverse events. A TER provided sustained long-term visual gains. Eyes with Type 1 neovascularization had better visual outcomes than those with other neovascular subtypes.

Original languageEnglish (US)
Pages (from-to)1380-1402
Number of pages23
JournalJournal of Clinical Medicine
Volume4
Issue number7
DOIs
StatePublished - Jul 8 2015
Externally publishedYes

Keywords

  • Anatomical classification
  • Choroidal neovascularization
  • Fluorescein angiography classification
  • Intravitreal anti-VEGF injections
  • Neovascular age-related macular degeneration
  • Treat and Extend Regimen

ASJC Scopus subject areas

  • Medicine(all)

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