TREATMENT OUTCOMES FOR NEOVASCULAR AGE-RELATED MACULAR DEGENERATION PATIENTS WITH INITIAL VISION BETTER THAN 20/40 USING A TREAT-AND-EXTEND REGIMEN.

Abstract

To determine treatment outcomes in eyes with neovascular age-related macular degeneration having visual acuity better than 20/40 after 1 years to 2 years of ranibizumab or bevacizumab therapy using a treat-and-extend regimen. Retrospective observational case series. Clinical records were reviewed from patients with treatment-naive neovascular age-related macular degeneration and baseline best-corrected Snellen visual acuity >20/40 treated with intravitreal ranibizumab or bevacizumab for a minimum of 1 year using a treat-and-extend regimen. The primary outcome measures were change from initial visual acuity, proportion of eyes losing <3 best-corrected visual acuity lines, proportion of eyes maintaining visual acuity ≥20/40, change from baseline central retinal thickness, and mean number of injections after 1 years and 2 years of follow-up. A total of 42 eyes from 40 patients were included. The mean follow-up period was 1.44 years. The mean initial logMAR visual acuity was 0.226, and remained stable at 0.257 and 0.267 after 1 years and 2 years of follow-up, respectively. At baseline, mean central retinal thickness was 305.8 μm, improved to 272.6 μm after 1 year of treatment (P < 0.001), and remained stable at 266.2 μm (P = 0.015) after 2 years. At 1-year follow-up period, 94.4% of eyes had lost less than 3 Snellen lines, and 94.1% of eyes lost less than 3 Snellen lines after 2 years. The percentage of eyes maintaining visual acuity ≥20/40 was 81% and 75% after each year. Eyes received on average 7.8 injections during the first year of treatment and 6.1 injections over the second year. Eyes with neovascular age-related macular degeneration presenting with initial visual acuity better than 20/40 on average maintained vision, lost less than 3 lines of acuity, and achieved anatomical improvements using a treat-and-extend regimen over a 2-year period.