1. MACULAR ATROPHY INCIDENCE IN ANTI-VASCULAR ENDOTHELIAL GROWTH FACTOR-TREATED NEOVASCULAR AGE-RELATED MACULAR DEGENERATION: Risk Factor Evaluation for Individualized Treatment Need of Ranibizumab or Aflibercept According to an Observe-and-Plan Regimen.
- Author
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Mantel I, Dirani A, Zola M, Parvin P, De Massougnes S, and Bergin C
- Subjects
- Aged, Angiogenesis Inhibitors administration & dosage, Angiogenesis Inhibitors adverse effects, Atrophy chemically induced, Atrophy diagnosis, Atrophy epidemiology, Disease Progression, Dose-Response Relationship, Drug, Female, Fluorescein Angiography, Fundus Oculi, Humans, Incidence, Intravitreal Injections, Macula Lutea drug effects, Male, Prognosis, Prospective Studies, Ranibizumab administration & dosage, Receptors, Vascular Endothelial Growth Factor administration & dosage, Receptors, Vascular Endothelial Growth Factor antagonists & inhibitors, Recombinant Fusion Proteins administration & dosage, Risk Factors, Switzerland epidemiology, Tomography, Optical Coherence, Wet Macular Degeneration diagnosis, Macula Lutea pathology, Ranibizumab adverse effects, Recombinant Fusion Proteins adverse effects, Visual Acuity, Wet Macular Degeneration drug therapy
- Abstract
Purpose: To investigate factors associated with macular atrophy (MA) incidence in neovascular age-related macular degeneration treated with either ranibizumab or aflibercept in an Observe-and-Plan variable dosing regimen., Methods: Information was obtained from two identical prospective treatment protocols using ranibizumab or aflibercept in a variable dosing regimen termed "Observe and Plan." Eyes without MA at baseline were included. New atrophy at the final 2-year visit was investigated with univariate and multivariate analysis to identify associated risk factors, focusing on treatment factors., Results: De novo MA developed in 63 (42%) of 149 eyes/patients (mean age 79.0 years), in 70 eyes treated using aflibercept and 79 eyes using ranibizumab. The univariate analysis showed multiple associations of MA with baseline factors, of which the following were confirmed as independent risk factors after multivariate stepwise logistic regression: lower number of anti-vascular endothelial growth factors injections (P = 0.011), depigmentation (P = 0.0004), reticular pseudodrusen (P = 0.0005), lower baseline visual acuity (P = 0.0006), and retinal angiomatous proliferation (P = 0.001). The drug type showed no significant association with MA incidence (P = 0.21)., Conclusion: Within the variable dosing regimen, MA incidence was higher when fewer injections were required. More injections, if required by disease activity, did not increase the risk for MA.
- Published
- 2019
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