Intravitreal aflibercept for exudative age-related macular degeneration with good visual acuity: 2-year results of a prospective study

Shinichi Sakamoto,1 Hidenori Takahashi,1,2 Yuji Inoue,1 Yusuke Arai,1 Satoru Inoda,1 Natsuko Kakinuma,2 Yujiro Fujino,2 Tatsuro Tanabe,2 Hidetoshi Kawashima,1 Yasuo Yanagi3–5 1Department of Ophthalmology, Jichi Medical University, Shimotsuke-shi, Tochigi, Japan; 2Department of Ophthalmolo...

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Autores principales:	Sakamoto S, Takahashi H, Inoue Y, Arai Y, Inoda S, Kakinuma N, Fujino Y, Tanabe T, Kawashima H, Yanagi Y
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2018
Materias:	polypoidal choroidal vasculopathy aflibercept age-related macular degeneration fixed regimen good visual acuity prospective study Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/4049f960fb5a40de924963cdd6f1dd45
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spelling	oai:doaj.org-article:4049f960fb5a40de924963cdd6f1dd452021-12-02T03:49:41ZIntravitreal aflibercept for exudative age-related macular degeneration with good visual acuity: 2-year results of a prospective study1177-5483https://doaj.org/article/4049f960fb5a40de924963cdd6f1dd452018-06-01T00:00:00Zhttps://www.dovepress.com/intravitreal-aflibercept-for-exudative-age-related-macular-degeneratio-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Shinichi Sakamoto,1 Hidenori Takahashi,1,2 Yuji Inoue,1 Yusuke Arai,1 Satoru Inoda,1 Natsuko Kakinuma,2 Yujiro Fujino,2 Tatsuro Tanabe,2 Hidetoshi Kawashima,1 Yasuo Yanagi3–5 1Department of Ophthalmology, Jichi Medical University, Shimotsuke-shi, Tochigi, Japan; 2Department of Ophthalmology, Japan Community Health Care Organization Tokyo Shinjuku Medical Center, Tokyo, Japan; 3Medical Retina, Singapore National Eye Centre, Singapore; 4Medical Retina, Singapore Eye Research Institute, Singapore; 5Eye-ACP, Duke NUS Medical School, National University of Singapore, Singapore Purpose: We report the 2-year outcomes of intravitreal aflibercept (IVA) for exudative age-related macular degeneration (AMD) with good visual acuity (VA) and examine the baseline factors associated with good visual outcome. Materials and methods: This multicenter, prospective study evaluated 39 eyes (39 AMD patients) enrolled from August 2013 to August 2014 at 12 and 24 months. Only patients with initial best-corrected VA (BCVA) >0.3 logarithm of the minimum angle of resolution (20/40 Snellen) were eligible. Three consecutive monthly IVA injections were followed by 2 monthly injections for 12 months. Thereafter, patients received injections on a treat-and-extend regimen for up to 24 months. Outcome measures included BCVA and central macular thickness (CMT) at 12 and 24 months. Post hoc analysis, BCVA, and CMT were evaluated by AMD types (typical AMD [tAMD], type 1, and type 2 polypoidal choroidal vasculopathy [PCV]). Baseline characteristics and BCVA associations were evaluated with linear regression analysis and Student’s t-test. Results: Mean age was 69 years and 26 of 39 eyes were male. tAMD, type 1 and type 2 PCV occurred in 18, 12, and 9 eyes, respectively. Baseline mean BCVA was 0.097 logarithm of the minimum angle of resolution (20/25 Snellen) and showed significant improvement to 0.058 (20/22 Snellen, P=0.03) at 12 months and 0.066 (20/23) at 24 months. CMT improved significantly from 320 (99) µm (mean [SD]) to 250 (93) µm (P=0.002) at 12 months and 240 (93) µm (P=0.0005) at 24 months. BCVA and CMT were not significantly different among the three groups. Only subretinal hemorrhage (SRH) was significantly associated with improved BCVA. BCVA change from baseline was -0.12 with SRH and -0.011 without SRH (P=0.017) at 12 months. Conclusion: IVA showed good efficacy for exudative AMD with good VA at 24 months. tAMD and type 1 and 2 PCV showed similar prognosis. Baseline SRH predicted favorable long-term vision in AMD with good VA. Keywords: polypoidal choroidal vasculopathy, aflibercept, age-related macular degeneration, fixed regimen, good visual acuity, prospective study, treat-and-extendSakamoto STakahashi HInoue YArai YInoda SKakinuma NFujino YTanabe TKawashima HYanagi YDove Medical Pressarticlepolypoidal choroidal vasculopathyafliberceptage-related macular degenerationfixed regimengood visual acuityprospective studyOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 12, Pp 1137-1147 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	polypoidal choroidal vasculopathy aflibercept age-related macular degeneration fixed regimen good visual acuity prospective study Ophthalmology RE1-994
spellingShingle	polypoidal choroidal vasculopathy aflibercept age-related macular degeneration fixed regimen good visual acuity prospective study Ophthalmology RE1-994 Sakamoto S Takahashi H Inoue Y Arai Y Inoda S Kakinuma N Fujino Y Tanabe T Kawashima H Yanagi Y Intravitreal aflibercept for exudative age-related macular degeneration with good visual acuity: 2-year results of a prospective study
description	Shinichi Sakamoto,1 Hidenori Takahashi,1,2 Yuji Inoue,1 Yusuke Arai,1 Satoru Inoda,1 Natsuko Kakinuma,2 Yujiro Fujino,2 Tatsuro Tanabe,2 Hidetoshi Kawashima,1 Yasuo Yanagi3–5 1Department of Ophthalmology, Jichi Medical University, Shimotsuke-shi, Tochigi, Japan; 2Department of Ophthalmology, Japan Community Health Care Organization Tokyo Shinjuku Medical Center, Tokyo, Japan; 3Medical Retina, Singapore National Eye Centre, Singapore; 4Medical Retina, Singapore Eye Research Institute, Singapore; 5Eye-ACP, Duke NUS Medical School, National University of Singapore, Singapore Purpose: We report the 2-year outcomes of intravitreal aflibercept (IVA) for exudative age-related macular degeneration (AMD) with good visual acuity (VA) and examine the baseline factors associated with good visual outcome. Materials and methods: This multicenter, prospective study evaluated 39 eyes (39 AMD patients) enrolled from August 2013 to August 2014 at 12 and 24 months. Only patients with initial best-corrected VA (BCVA) >0.3 logarithm of the minimum angle of resolution (20/40 Snellen) were eligible. Three consecutive monthly IVA injections were followed by 2 monthly injections for 12 months. Thereafter, patients received injections on a treat-and-extend regimen for up to 24 months. Outcome measures included BCVA and central macular thickness (CMT) at 12 and 24 months. Post hoc analysis, BCVA, and CMT were evaluated by AMD types (typical AMD [tAMD], type 1, and type 2 polypoidal choroidal vasculopathy [PCV]). Baseline characteristics and BCVA associations were evaluated with linear regression analysis and Student’s t-test. Results: Mean age was 69 years and 26 of 39 eyes were male. tAMD, type 1 and type 2 PCV occurred in 18, 12, and 9 eyes, respectively. Baseline mean BCVA was 0.097 logarithm of the minimum angle of resolution (20/25 Snellen) and showed significant improvement to 0.058 (20/22 Snellen, P=0.03) at 12 months and 0.066 (20/23) at 24 months. CMT improved significantly from 320 (99) µm (mean [SD]) to 250 (93) µm (P=0.002) at 12 months and 240 (93) µm (P=0.0005) at 24 months. BCVA and CMT were not significantly different among the three groups. Only subretinal hemorrhage (SRH) was significantly associated with improved BCVA. BCVA change from baseline was -0.12 with SRH and -0.011 without SRH (P=0.017) at 12 months. Conclusion: IVA showed good efficacy for exudative AMD with good VA at 24 months. tAMD and type 1 and 2 PCV showed similar prognosis. Baseline SRH predicted favorable long-term vision in AMD with good VA. Keywords: polypoidal choroidal vasculopathy, aflibercept, age-related macular degeneration, fixed regimen, good visual acuity, prospective study, treat-and-extend
format	article
author	Sakamoto S Takahashi H Inoue Y Arai Y Inoda S Kakinuma N Fujino Y Tanabe T Kawashima H Yanagi Y
author_facet	Sakamoto S Takahashi H Inoue Y Arai Y Inoda S Kakinuma N Fujino Y Tanabe T Kawashima H Yanagi Y
author_sort	Sakamoto S
title	Intravitreal aflibercept for exudative age-related macular degeneration with good visual acuity: 2-year results of a prospective study
title_short	Intravitreal aflibercept for exudative age-related macular degeneration with good visual acuity: 2-year results of a prospective study
title_full	Intravitreal aflibercept for exudative age-related macular degeneration with good visual acuity: 2-year results of a prospective study
title_fullStr	Intravitreal aflibercept for exudative age-related macular degeneration with good visual acuity: 2-year results of a prospective study
title_full_unstemmed	Intravitreal aflibercept for exudative age-related macular degeneration with good visual acuity: 2-year results of a prospective study
title_sort	intravitreal aflibercept for exudative age-related macular degeneration with good visual acuity: 2-year results of a prospective study
publisher	Dove Medical Press
publishDate	2018
url	https://doaj.org/article/4049f960fb5a40de924963cdd6f1dd45
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Intravitreal aflibercept for exudative age-related macular degeneration with good visual acuity: 2-year results of a prospective study

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