Five-year outcomes of intravitreal drug therapy for neovascular age-related macular degeneration in eyes with baseline vision 20/60 or better

Arshad M Khanani,1 Greggory M Gahn,2 Micaela M Koci,2 Jonathan M Dang,2 Sandra M Brown,3 Lauren F Hill4 1Sierra Eye Associates, Reno, NV, USA; 2School of Medicine, University of Nevada, Reno, NV, USA; 3Cabarrus Eye Center, Concord, NC, USA; 4Hill Statistical Consulting, Morrison, CO, USA...

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Autores principales:	Khanani AM, Gahn GM, Koci MM, Dang JM, Brown SM, Hill LF
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2019
Materias:	neovascular age related macular degeneration ranibizumab aflibercept bevacizumab treat and extend protocol visual acuity Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/c49387feb08741afa36e43f325e0bf67
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spelling	oai:doaj.org-article:c49387feb08741afa36e43f325e0bf672021-12-02T07:10:20ZFive-year outcomes of intravitreal drug therapy for neovascular age-related macular degeneration in eyes with baseline vision 20/60 or better1177-5483https://doaj.org/article/c49387feb08741afa36e43f325e0bf672019-02-01T00:00:00Zhttps://www.dovepress.com/five-year-outcomes-of-intravitreal-drug-therapy-for-neovascular-age-re-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Arshad M Khanani,1 Greggory M Gahn,2 Micaela M Koci,2 Jonathan M Dang,2 Sandra M Brown,3 Lauren F Hill4 1Sierra Eye Associates, Reno, NV, USA; 2School of Medicine, University of Nevada, Reno, NV, USA; 3Cabarrus Eye Center, Concord, NC, USA; 4Hill Statistical Consulting, Morrison, CO, USA Objective: To assess outcomes in treatment-naive eyes with neovascular age-related macular degeneration (nAMD) and good baseline visual acuity (VA) treated using a treat-and-extend (T&E) regimen with intravitreal aflibercept, ranibizumab, or bevacizumab. Design: Single center, retrospective, observational case series. Participants: Ninety-one patients (93 eyes) with nAMD and baseline VA ≥20/60 followed for ≥1 year after the first intravitreal injection. Minimum of 6 (first year) and 3 (subsequent years) and maximum of 12 injections per 12 calendar months. Intervention: Intravitreal aflibercept 2.0 mg, ranibizumab 0.5 mg, or bevacizumab 1.25 mg. Three monthly injections. Treatment interval extended in 2-week increments after resolution of macular edema and reduced in 2-week increments if edema recurred; maximum interval of 12 weeks. Medication changed if edema recurred during and persisted after three monthly injections of original agent. Main outcome measures: VA maintenance over time. Total number of injections received by year of treatment. Results: Ninety-three eyes were analyzed. Pretreatment VA was 20/20–20/25 (N=16), 20/30–20/40 (N=47), and 20/50–20/60 (N=30). Mean follow-up was 3.2 years. Follow-up by year was 93, 73, 65, 44, and 26 eyes for years 1–5, respectively. Mean number of injections during years 1–5 was 7.9, 5.9, 5.6, 5.9, and 6.0, respectively; mode number of injections was 7, 5, 3, 6, and 4, respectively. For years 1–5, percent of all eyes at or above baseline was 70%, 66%, 65%, 59%, and 58%, respectively; percent ≥20/60 was 86%, 88%, 86%, 84%, and 77% for years 1–5. For eyes with baseline VA ≥20/40, percent of eyes at or above baseline was 83%, 82%, 81%, 68% and 76% for years 1–5, respectively. Conclusion: Using a T&E intravitreal injection protocol, more than 75% of treatment-naive eyes with nAMD and baseline VA ≥20/60 can maintain VA ≥20/60 over 5 years. Keywords: neovascular age-related macular degeneration, ranibizumab, aflibercept, bevacizumab, treat and extend protocol, visual acuityKhanani AMGahn GMKoci MMDang JMBrown SMHill LFDove Medical Pressarticleneovascular age related macular degenerationranibizumabafliberceptbevacizumabtreat and extend protocolvisual acuityOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 13, Pp 347-351 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	neovascular age related macular degeneration ranibizumab aflibercept bevacizumab treat and extend protocol visual acuity Ophthalmology RE1-994
spellingShingle	neovascular age related macular degeneration ranibizumab aflibercept bevacizumab treat and extend protocol visual acuity Ophthalmology RE1-994 Khanani AM Gahn GM Koci MM Dang JM Brown SM Hill LF Five-year outcomes of intravitreal drug therapy for neovascular age-related macular degeneration in eyes with baseline vision 20/60 or better
description	Arshad M Khanani,1 Greggory M Gahn,2 Micaela M Koci,2 Jonathan M Dang,2 Sandra M Brown,3 Lauren F Hill4 1Sierra Eye Associates, Reno, NV, USA; 2School of Medicine, University of Nevada, Reno, NV, USA; 3Cabarrus Eye Center, Concord, NC, USA; 4Hill Statistical Consulting, Morrison, CO, USA Objective: To assess outcomes in treatment-naive eyes with neovascular age-related macular degeneration (nAMD) and good baseline visual acuity (VA) treated using a treat-and-extend (T&E) regimen with intravitreal aflibercept, ranibizumab, or bevacizumab. Design: Single center, retrospective, observational case series. Participants: Ninety-one patients (93 eyes) with nAMD and baseline VA ≥20/60 followed for ≥1 year after the first intravitreal injection. Minimum of 6 (first year) and 3 (subsequent years) and maximum of 12 injections per 12 calendar months. Intervention: Intravitreal aflibercept 2.0 mg, ranibizumab 0.5 mg, or bevacizumab 1.25 mg. Three monthly injections. Treatment interval extended in 2-week increments after resolution of macular edema and reduced in 2-week increments if edema recurred; maximum interval of 12 weeks. Medication changed if edema recurred during and persisted after three monthly injections of original agent. Main outcome measures: VA maintenance over time. Total number of injections received by year of treatment. Results: Ninety-three eyes were analyzed. Pretreatment VA was 20/20–20/25 (N=16), 20/30–20/40 (N=47), and 20/50–20/60 (N=30). Mean follow-up was 3.2 years. Follow-up by year was 93, 73, 65, 44, and 26 eyes for years 1–5, respectively. Mean number of injections during years 1–5 was 7.9, 5.9, 5.6, 5.9, and 6.0, respectively; mode number of injections was 7, 5, 3, 6, and 4, respectively. For years 1–5, percent of all eyes at or above baseline was 70%, 66%, 65%, 59%, and 58%, respectively; percent ≥20/60 was 86%, 88%, 86%, 84%, and 77% for years 1–5. For eyes with baseline VA ≥20/40, percent of eyes at or above baseline was 83%, 82%, 81%, 68% and 76% for years 1–5, respectively. Conclusion: Using a T&E intravitreal injection protocol, more than 75% of treatment-naive eyes with nAMD and baseline VA ≥20/60 can maintain VA ≥20/60 over 5 years. Keywords: neovascular age-related macular degeneration, ranibizumab, aflibercept, bevacizumab, treat and extend protocol, visual acuity
format	article
author	Khanani AM Gahn GM Koci MM Dang JM Brown SM Hill LF
author_facet	Khanani AM Gahn GM Koci MM Dang JM Brown SM Hill LF
author_sort	Khanani AM
title	Five-year outcomes of intravitreal drug therapy for neovascular age-related macular degeneration in eyes with baseline vision 20/60 or better
title_short	Five-year outcomes of intravitreal drug therapy for neovascular age-related macular degeneration in eyes with baseline vision 20/60 or better
title_full	Five-year outcomes of intravitreal drug therapy for neovascular age-related macular degeneration in eyes with baseline vision 20/60 or better
title_fullStr	Five-year outcomes of intravitreal drug therapy for neovascular age-related macular degeneration in eyes with baseline vision 20/60 or better
title_full_unstemmed	Five-year outcomes of intravitreal drug therapy for neovascular age-related macular degeneration in eyes with baseline vision 20/60 or better
title_sort	five-year outcomes of intravitreal drug therapy for neovascular age-related macular degeneration in eyes with baseline vision 20/60 or better
publisher	Dove Medical Press
publishDate	2019
url	https://doaj.org/article/c49387feb08741afa36e43f325e0bf67
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Five-year outcomes of intravitreal drug therapy for neovascular age-related macular degeneration in eyes with baseline vision 20/60 or better

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