Switching from pro re nata
 to treat-and-extend regimen improves visual acuity in patients with neovascular age-related macular degeneration

Purpose: This study investigated the 1-year outcomes of a treat-and-extend regimen of ranibizumab for exudative age-related macular degeneration and examined the clinical results when drug treatment was changed within the same period. Methods: This retrospective analysis included 32 eyes first diagnosed with wet age-related macular degeneration and treated for more than 1 year with a treat-and-extend regimen of ranibizumab, as well as 24 eyes treated by changing from ranibizumab to aflibercept within the same period. The injection number, maximum injection interval, change in central retinal thickness, and best-corrected visual acuity were assessed in all eyes. Results: In 32 eyes that received a treat-and-extend regimen of ranibizumab, the mean best-corrected visual acuity improved from 59.46 ± 15.13 to 68.00 ± 12.48 at 12 months (p < 0.0001). The mean central retinal thickness decreased from 409 ± 141 μm to 273 ± 89 μm at 12 months (p < 0.0001). The average number of injections per year was 7.2 ± 0.85. One complication related to the 12 months of injections was a tear in the retinal pigment epithelium; no systemic complications were observed. Of 24 eyes that underwent a change in medication, the rate of maintenance or improvement in initial visual acuity was 83% (10 eyes). The central retinal thickness was initially 371.58 ± 109.96 μm, but improved to 290.33 ± 58.66 μm in 12 eyes that received three injections of aflibercept. Conclusions: At 1 year, good outcomes were obtained using treat-and-extend ranibizumab for exudative age-related macular degeneration. When the treatment was changed to aflibercept within the same period, vision was often maintained and short-term anatomical improvement was evident.

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Recurrent neovascular age-related macular degeneration after discontinuation of VEGF inhibitors managed in a treat and extend regimen

Ophthalmology Retina ◽

10.1016/j.oret.2021.03.010 ◽

2021 ◽

Author(s):

Stamatios Aslanis ◽

Urban Amrén ◽

Charlotte Lindberg ◽

David Epstein

Keyword(s):

Macular Degeneration ◽

Age Related Macular Degeneration ◽

Vegf Inhibitors ◽

Treat And Extend ◽

Age Related ◽

Treat And Extend Regimen

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Baseline Optical Coherence Tomography Findings as Outcome Predictors after Switching from Ranibizumab to Aflibercept in Neovascular Age-Related Macular Degeneration following a Treat-and-Extend Regimen

Ophthalmologica ◽

10.1159/000477856 ◽

2017 ◽

Vol 238 (3) ◽

pp. 172-178 ◽

Cited By ~ 3

Author(s):

Cengiz Türksever ◽

Christian Prünte ◽

Katja Hatz

Keyword(s):

Optical Coherence Tomography ◽

Macular Degeneration ◽

Age Related Macular Degeneration ◽

Outcome Predictors ◽

Optical Coherence ◽

Treat And Extend ◽

Age Related ◽

Treat And Extend Regimen

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Aflibercept for age-related macular degeneration: 4-year outcomes of a ‘treat-and-extend’ regimen with exit-strategy

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2020-316514 ◽

2020 ◽

pp. bjophthalmol-2020-316514

Author(s):

Damian Jaggi ◽

Thanoosha Nagamany ◽

Andreas Ebneter ◽

Marion Munk ◽

Sebastian Wolf ◽

...

Keyword(s):

Macular Degeneration ◽

Age Related Macular Degeneration ◽

Long Term Outcomes ◽

Treat And Extend ◽

Age Related ◽

Central Subfield Thickness ◽

Treatment Naïve ◽

Treat And Extend Regimen

AimTo report long-term outcomes on best-corrected visual acuity (BCVA) and treatment intervals with a treat-and-extend (T&E) regimen in patients with neovascular age-related macular degeneration (nAMD).MethodsThis observational study included treatment-naïve patients with nAMD, treated with aflibercept. A specific T&E protocol without a loading phase and predefined exit criteria was administered. After reaching predefined ‘exit-criteria’, the treatment period was complete, and patients were observed three monthly.ResultsEighty-two patients with a follow-up period of ≥2 years were included. BCVA (mean±SD, ETDRS letters) increased from 51.9±25.2 at baseline to 63.7±17.7 (p<0.0001) at 1 year, 61.7±18.5 (p<0.0001) at 2 years, 62.4±19.5 (p<0.0001, n=61) at 3 years and remained insignificantly higher than baseline at 4 years at 58.5±24.3 (p=0.22). Central subfield thickness (mean±SD, μm) decreased significantly from 387.5±107.6 (p<0.0001) at baseline to 291.9±65.5 (p<0.0001) at 1 year, and remained significantly lower until 4 years at 289.0±59.4 (p<0.0001). Treatment intervals (mean±SD, weeks) could be extended up to 9.3±3.1 weeks at 1 year and remained at 11.2±3.5 weeks at 4 years. Twenty-nine (35%) patients reached exit criteria and continued with three monthly observation only.ConclusionsAfter 4 years of treatment, initial vision gains were maintained with a reasonable treatment burden, even without an initial loading phase. Our results on functional outcomes are comparable with large controlled studies.

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