Two-Year Outcomes of "Treat and Extend" Intravitreal Therapy for Neovascular Age-Related Macular Degeneration
Purpose: To report 24-month outcomes of anti-vascular endothelial growth factor (VEGF) therapy for treatment-naïve eyes with neovascular age-related macular degeneration (nAMD) using a treat and extend treatment regimen in routine clinical practice. Design: Database observational study. Participants...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Journal Article |
| Published: |
Elsevier Inc.
2014
|
| Online Access: | http://hdl.handle.net/20.500.11937/49917 |
| _version_ | 1848758349237059584 |
|---|---|
| author | Arnold, J. Campain, A. Barthelmes, D. Simpson, J. Guymer, R. Hunyor, A. McAllister, I. Essex, R. Morlet, Nigel Gillies, M. |
| author_facet | Arnold, J. Campain, A. Barthelmes, D. Simpson, J. Guymer, R. Hunyor, A. McAllister, I. Essex, R. Morlet, Nigel Gillies, M. |
| author_sort | Arnold, J. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | Purpose: To report 24-month outcomes of anti-vascular endothelial growth factor (VEGF) therapy for treatment-naïve eyes with neovascular age-related macular degeneration (nAMD) using a treat and extend treatment regimen in routine clinical practice. Design: Database observational study. Participants: We included treatment-naïve eyes receiving predominantly ranibizumab for nAMD in routine clinical practice treated using a treat and extend regimen that were tracked in the Fight Retinal Blindness observational registry. Methods: A cohort of eyes treated by practitioners using exclusively a treat and extend regimen was extracted from the Fight Retinal Blindness observational registry. Main Outcome Measures: Change in visual acuity (VA) over 2 years and number of injections and visits. Results: Data from 1198 eyes from 1011 patients receiving anti-VEGF therapy using a treat and extend regimen for treatment-naïve nAMD between January 2007 and December 2012 and with 24-month follow-up were included in the analysis. Mean VA increased by+5.3 logarithm of the minimum angle of resolution letters from 56.5 letters (20/80+1) at initial visit to 61.8 (20/60+2) letters at 24 months. Mean VA gains improved and number of injections increased with successive years from+2.7 letters for eyes commencing in 2007 after a mean of 9.7 injections in 2 years, to+7.8 letters for eyes commencing in 2012 after a mean of 14.2 injections over 2 years. The proportion of eyes with VA >20/40 increased from 27% when starting treatment to 45% after 24 months; the proportion with vision of <20/200 remained unchanged (13% initial, 11% at 24 months). Of the included eyes, 90.5% avoided a vision loss of =15 letters. There was an overall mean of 13.0 injections over the 24 months, 7.5 injections in the first year and 5.5 in the second year, with a mean of 14.8 clinic visits. Conclusions: These data indicate that eyes managed in routine clinical practice with a treat and extend regimen can achieve good visual outcomes while decreasing the burden of treatments and clinic visits. |
| first_indexed | 2025-11-14T09:42:34Z |
| format | Journal Article |
| id | curtin-20.500.11937-49917 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| last_indexed | 2025-11-14T09:42:34Z |
| publishDate | 2014 |
| publisher | Elsevier Inc. |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-499172017-09-13T15:49:27Z Two-Year Outcomes of "Treat and Extend" Intravitreal Therapy for Neovascular Age-Related Macular Degeneration Arnold, J. Campain, A. Barthelmes, D. Simpson, J. Guymer, R. Hunyor, A. McAllister, I. Essex, R. Morlet, Nigel Gillies, M. Purpose: To report 24-month outcomes of anti-vascular endothelial growth factor (VEGF) therapy for treatment-naïve eyes with neovascular age-related macular degeneration (nAMD) using a treat and extend treatment regimen in routine clinical practice. Design: Database observational study. Participants: We included treatment-naïve eyes receiving predominantly ranibizumab for nAMD in routine clinical practice treated using a treat and extend regimen that were tracked in the Fight Retinal Blindness observational registry. Methods: A cohort of eyes treated by practitioners using exclusively a treat and extend regimen was extracted from the Fight Retinal Blindness observational registry. Main Outcome Measures: Change in visual acuity (VA) over 2 years and number of injections and visits. Results: Data from 1198 eyes from 1011 patients receiving anti-VEGF therapy using a treat and extend regimen for treatment-naïve nAMD between January 2007 and December 2012 and with 24-month follow-up were included in the analysis. Mean VA increased by+5.3 logarithm of the minimum angle of resolution letters from 56.5 letters (20/80+1) at initial visit to 61.8 (20/60+2) letters at 24 months. Mean VA gains improved and number of injections increased with successive years from+2.7 letters for eyes commencing in 2007 after a mean of 9.7 injections in 2 years, to+7.8 letters for eyes commencing in 2012 after a mean of 14.2 injections over 2 years. The proportion of eyes with VA >20/40 increased from 27% when starting treatment to 45% after 24 months; the proportion with vision of <20/200 remained unchanged (13% initial, 11% at 24 months). Of the included eyes, 90.5% avoided a vision loss of =15 letters. There was an overall mean of 13.0 injections over the 24 months, 7.5 injections in the first year and 5.5 in the second year, with a mean of 14.8 clinic visits. Conclusions: These data indicate that eyes managed in routine clinical practice with a treat and extend regimen can achieve good visual outcomes while decreasing the burden of treatments and clinic visits. 2014 Journal Article http://hdl.handle.net/20.500.11937/49917 10.1016/j.ophtha.2015.02.009 Elsevier Inc. restricted |
| spellingShingle | Arnold, J. Campain, A. Barthelmes, D. Simpson, J. Guymer, R. Hunyor, A. McAllister, I. Essex, R. Morlet, Nigel Gillies, M. Two-Year Outcomes of "Treat and Extend" Intravitreal Therapy for Neovascular Age-Related Macular Degeneration |
| title | Two-Year Outcomes of "Treat and Extend" Intravitreal Therapy for Neovascular Age-Related Macular Degeneration |
| title_full | Two-Year Outcomes of "Treat and Extend" Intravitreal Therapy for Neovascular Age-Related Macular Degeneration |
| title_fullStr | Two-Year Outcomes of "Treat and Extend" Intravitreal Therapy for Neovascular Age-Related Macular Degeneration |
| title_full_unstemmed | Two-Year Outcomes of "Treat and Extend" Intravitreal Therapy for Neovascular Age-Related Macular Degeneration |
| title_short | Two-Year Outcomes of "Treat and Extend" Intravitreal Therapy for Neovascular Age-Related Macular Degeneration |
| title_sort | two-year outcomes of "treat and extend" intravitreal therapy for neovascular age-related macular degeneration |
| url | http://hdl.handle.net/20.500.11937/49917 |