1. Injection burden and treatment intervals of aflibercept in observe-and-plan regimen for neovascular age-related macular degeneration.
- Author
-
Subhi Y, Schneider M, Hajari JN, and la Cour M
- Subjects
- Humans, Retrospective Studies, Female, Male, Aged, Follow-Up Studies, Aged, 80 and over, Fluorescein Angiography methods, Macula Lutea pathology, Macula Lutea diagnostic imaging, Treatment Outcome, Time Factors, Dose-Response Relationship, Drug, Registries, Fundus Oculi, Drug Administration Schedule, Vascular Endothelial Growth Factor A antagonists & inhibitors, Recombinant Fusion Proteins administration & dosage, Receptors, Vascular Endothelial Growth Factor administration & dosage, Receptors, Vascular Endothelial Growth Factor therapeutic use, Intravitreal Injections, Wet Macular Degeneration drug therapy, Wet Macular Degeneration diagnosis, Tomography, Optical Coherence methods, Visual Acuity, Angiogenesis Inhibitors administration & dosage
- Abstract
Purpose: The Observe-and-Plan (O&P) regimen allows for individualised treatment. In this study, we evaluated injection burden and intervals using aflibercept in an O&P regimen for eyes with neovascular age-related macular degeneration (AMD)., Methods: This was a retrospective registry-based study of treatment-naïve eyes with neovascular AMD. Treatment data were compiled for 3 years after commencement of intravitreal aflibercept therapy. We evaluated clinical consequences at the first follow-up after loading dose, the proportion of patients who obtained and kept dry macula after loading dose, number of injections and intervals between injections., Results: Data were obtained for 1103 eyes. After loading dose, 0.4% were lost to follow-up, 7.5% discontinued, 50.9% booked for further injections and 41.3% booked for monthly observations. After loading dose, the macula remained dry in 49.2% at 3 months, 34.0% at 6 months, 23.7% at 12 months and 15.2% at 24 months. For the entire population, median cumulative total number of injections was 7, 12 and 15, after 1, 2 and 3 years, respectively. After the 3rd year, the proportion of eyes in the short 4-6 weeks treatment interval was 51.1%, 8 weeks interval was kept in 14.4% and the extended treatment intervals of 10 and 12 weeks was possible in 34.4%., Conclusion: After loading dose, one in two eyes required further injections. A large proportion required therapy with shorter intervals than the label-recommended 8 weeks. The large majority of those who obtained a dry macula after loading dose turned exudative again, mostly within the first 3 months., (© 2024 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.)
- Published
- 2024
- Full Text
- View/download PDF