What Is the Best Neovascular Age-related Macular Degeneration Treatment Regime for 2016?

2015 ◽  
Vol 09 (02) ◽  
pp. 157
Author(s):  
Richard P Gale ◽  
◽  
◽  
Reema Gupta
Keyword(s):  
Macular Degeneration ◽  
Healthcare Systems ◽  
Age Related Macular Degeneration ◽  
Treatment Burden ◽  
Intravitreal Therapy ◽  
Treatment Regimens ◽  
Treatment Interval ◽  
Age Related ◽  
Significant Step ◽  
The Common

The management of neovascular age-related macular degeneration (nvAMD) has evolved significantly over the last few years with a significant step forward being taken with the advent of intravitreal therapy. Many different treatment regimens can be used, and the goal of treatment is shifting away from just salvaging vision to include reducing treatment burden on patients, carers and healthcare systems. This editorial discusses the common treatment regimens and proposes a pragmatic way of treating patients in three steps: (1) initiating a treatment, (2) finding the appropriate re-treatment interval and (3) fixing the re-treatment interval.

Aflibercept in real-life for the treatment of age-related macular degeneration using a treat and extend protocol: The Armada study

2021 ◽  
pp. 112067212110057
Author(s):  
Pierre Gascon ◽  
Prithvi Ramtohul ◽  
Charles Delaporte ◽  
Sébastien Kerever ◽  
Danièle Denis ◽  
...  
Keyword(s):  
Macular Degeneration ◽  
Real Life ◽  
Age Related Macular Degeneration ◽  
Cumulative Number ◽  
Treat And Extend ◽  
Treatment Interval ◽  
Age Related ◽  
Treatment Naïve ◽  
The Mean

Purpose: To report the visual and anatomic outcomes in treatment-naïve neovascular age-related macular degeneration (nAMD) patients treated with aflibercept under a standardized Treat and Extend (T&E) protocol for up to 3 years of follow-up in “real-life” practice. Methods: This retrospective, observational, multicenter study included patients with treatment-naïve nAMD and at least 12 months of follow-up. T&E regimen adjustment was initiated after loading phase. At each visit best-corrected visual acuity (BCVA) and optical coherence tomography parameters were performed. Results: One hundred and thirty-six eyes of 115patients had at least 1 year of follow-up with 114 and 82 eyes completing at least 2 and 3 years of follow-up, respectively (mean follow-up duration: 2.7 ± 1.3 years). Mean age was 78.6 ± 8.6 years old and 52% were women. Mean BCVA increased from 60.6 ± 18.7 letters at diagnosis to 66.9 ± 16.2 letters at 1 year (+6.3 letters, p = 0.003) and remained stable throughout the follow-up period (63.1 ± 20.3 letters (+2.5, p = 0.1) and 64.0 ± 20.1 letters (+3.4, p = 0.27) at 2 and 3 years, respectively). The mean central retinal thickness decreased significantly from 358.2 ± 87.9 µm at baseline to 302 ± 71.7 µm at 12 months and maintained stable after 36 months of follow-up (297.1 ± 76 µm, p < 0.0001). Mean number of injections was 6.6 ± 2.2, 4.8 ± 1.9, and 5.6 ± 1.7 at 1, 2, and 3 years, respectively. Mean cumulative number of 16.4 ± 5.6 injections after 3 years. Mean treatment interval was 6.8 ± 2.5 weeks at 1 year. Eight-week and 12-week treatment interval were achieved in 59.5% and 19.1%, 65.8%, and 36.8% and 69.5% and 41.5% at 1, 2, and 3 years, respectively. Conclusions: Our study demonstrated that intravitreal injections of aflibercept initiated under a standardized T&E for patients with treatment-naïve nAMD allow for significant visual improvement at 12 months, which was maintained over a 3-year follow-up period.

scholarly journals Clustering of eyes with age-related macular degeneration or pachychoroid spectrum diseases based on choroidal thickness profile

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Young Ho Kim ◽  
Boram Lee ◽  
Edward Kang ◽  
Jaeryung Oh
Keyword(s):  
Macular Degeneration ◽  
Choroidal Thickness ◽  
Age Related Macular Degeneration ◽  
Age Related ◽  
Soft Drusen ◽  
Pachychoroid Neovasculopathy ◽  
The Common ◽  
Common Pathogenesis ◽  
Clustering Pattern ◽  
Normal Controls

AbstractChoroidal changes have been suggested to be involved in the pathophysiology of both age-related macular degeneration (AMD) and pachychoroid spectrum diseases (PSD). To find out the choroidal characteristics of each disease groups, various groups of AMD and PSD were classified into several clusters according to choroidal profiles based on subfoveal choroidal thickness (CT), peripapillary CT, the ratio of subfoveal CT to peripapillary CT and age. We retrospectively analyzed 661 eyes, including 190 normal controls and 471 with AMD or PSDs. In the AMD groups, eyes with soft drusen or reticular pseudodrusen were belonged to the same cluster as those with classic exudative AMD (all p < 0.001). However, eyes with pachydrusen were not clustered with eyes from other AMD groups; instead, they were classified in the same cluster as eyes from the PSD group (all p < 0.001). In the PSD group, eyes with pachychoroid neovasculopathy were grouped in the same cluster of those with polypoidal choroidal vasculopathy (p < 0.001). The cluster analysis based on the CT profiles, including subfoveal CT, peripapillary CT, and their ratio, revealed a clustering pattern of eyes with AMD and PSDs. These findings support the suggestion that pachydrusen has the common pathogenesis as PSD.

scholarly journals New Approach of Anti-VEGF Agents for Age-Related Macular Degeneration

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Young Gun Park ◽  
Hyun Wook Rhu ◽  
Seungbum Kang ◽  
Young Jung Roh
Keyword(s):  
Macular Degeneration ◽  
Visual Outcome ◽  
Standard Of Care ◽  
Age Related Macular Degeneration ◽  
Treatment Frequency ◽  
New Approach ◽  
Treatment Regimens ◽  
Anti Vegf ◽  
Age Related ◽  
The Many

Age-related macular degeneration (AMD) is the leading cause of visual loss in older population. Angiogenesis is an important factor associated with the development of CNV due to AMD. Treatment of CNV with intravitreal anti-VEGF monotherapy is currently the standard of care. However, not all patients respond to monotherapy, and modified anti-VEGF treatment regimen and combination therapy may target reducing treatment frequency or improving visual outcome. This paper reviews the many clinical trials that have been performed utilizing several treatment regimens. While many trials have shown that this variable therapy is justifiable, further study is required to determine correct regimens and dosage.

scholarly journals Intravitreal Ranibizumab Treatment and Treatment Regimens in Wet-Form (Neovascular) Age-Related Macular Degeneration

2017 ◽  
pp. 189-197
Keyword(s):  
Macular Degeneration ◽  
Progressive Disease ◽  
Vision Loss ◽  
Age Related Macular Degeneration ◽  
Therapeutic Tool ◽  
Intravitreal Ranibizumab ◽  
Treatment Regimens ◽  
Age Related ◽  
Ranibizumab Treatment

Age-related macular degeneration (AMD) is a chronic and progressive disease of the central retina that causes vision loss in people over 50 years of age. With an understanding of the role of VEGF in AMD, intravitreal anti-VEGF agents are used as the most important therapeutic tool in the management of AMD. In this review we try to discuss intravitreal ranibizumab treatment and treatment regimens in wet (neovascular) age-related macular degeneration.

scholarly journals Implementation of An Intravitreal Therapy Online Audit Tool For Neovascular Age-related Macular Degeneration Clinical Outcomes Reporting: Fight Retinal Blindness Spain (FRB-Spain) Project

2021 ◽  
Author(s):  
Alba Parrado-Carrillo ◽  
Marc Figueras-Roca ◽  
Ricardo P. Casaroli-Marano ◽  
Vuong Nguyen ◽  
Daniel Barthelmes ◽  
...  
Keyword(s):  
Macular Degeneration ◽  
Subgroup Analysis ◽  
Real Life ◽  
Age Related Macular Degeneration ◽  
Audit Tool ◽  
Intravitreal Therapy ◽  
Tertiary Referral Center ◽  
Anti Vegf ◽  
Age Related ◽  
Number Of Injections

Abstract Purpose: To implement an intravitreal therapy audit tool for neovascular age-related macular degeneration (nAMD) outcome reporting in a tertiary referral center. Methods: Implementation of an online audit tool (Fight Retinal Blindness platform) for nAMD eyes receiving anti-vascular endothelial growth factor (anti-VEGF) intravitreal therapy over a 24-month follow-up period. Data entry was compliant with the ICHOM dataset for nAMD. These data included visual acuity (VA), eye conditions, injection drug and number of injections. Subgroup analysis was performed for treatment-naive (TN) and previously treated (PT) eyes. Results: 234 eyes (191 patients) were included in the study. No significant differences were observed in the subgroup analysis in mean baseline VA (logMAR letters: 58.8 TN vs 62.7 PT, p= 0.081) or final VA at 12 months (TN 61.4 vs PT 62.4; p= 0.703). However, 12 months median VA change favoured TN cases (+4 TN vs +0 PT, p= 0.010) and median number of injections showed no differences (7 TN vs 7 PT, p= 0.644). No statistically significant differences were found at two years on number of injections even though mean final VA showed significant differences (66 TN vs 59.5 PT, p = 0.032) and VA change favoured the TN group (+2.4 TN vs - 4.6 PT, p= 0.003).Conclusion: We have successfully implemented an online tool to evaluate nAMD anti-VEGF treatment delivered in our center. This feasibility study demonstrates that the online audit tool allows evaluating real world intravitreal therapy outcomes and benchmark these results with clinical practice guidelines and other real-life series.

scholarly journals The Common Antidiabetic Drug Metformin Reduces Odds of Developing Age-Related Macular Degeneration

2019 ◽  
Vol 60 (5) ◽  
pp. 1470 ◽  
Author(s):  
Emily E. Brown ◽  
Jacob D. Ball ◽  
Zhaoyi Chen ◽  
Gibran S. Khurshid ◽  
Mattia Prosperi ◽  
...  
Keyword(s):  
Macular Degeneration ◽  
Age Related Macular Degeneration ◽  
Antidiabetic Drug ◽  
Age Related ◽  
The Common
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