Visual Outcome and Treatment Frequency of Anti-VEGF Therapy Using the Treat-and-Extend and Treatment Cessation Regimen for Exudative Age-Related Macular Degeneration and Pachychoroid Neovasculopathy

Takamasa Kinoshita, Junya Mori, Akira Hatanaka, Miho Shimizu, Hiroko Imaizumi Department of Ophthalmology, Sapporo City General Hospital, Sapporo, JapanCorrespondence: Takamasa KinoshitaDepartment of Ophthalmology, Sapporo City General Hospital, 1-1, N-11, W-13, Chuoku, Sapporo, 060-8604, JapanTel +81 11 726 2211Fax +81 11 726 9541Email knst129@gmail.comPurpose: To report the results of anti-vascular endothelial growth factor (VEGF) therapy using treat-and-extend (TAE) and treatment cessation regimens for exudative age-related macular degeneration (AMD) and pachychoroid neovasculopathy (PN).Methods: We retrospectively studied 101 treatment-naïve eyes of 101 patients with exudative AMD and PN that underwent anti-VEGF therapy using TAE and treatment cessation regimen with a follow-up period of ≥ 12 months. Best-corrected visual acuity (BCVA), treatment frequency, and number of eyes with successful treatment cessation were measured. Successful treatment cessation was defined as dry macula retention without treatment for > 16 weeks after the last injections. Factors related to the successful treatment cessation were evaluated.Results: BCVA was maintained at the last visit with a mean follow-up period of 49.9 ± 26.9 months. The injection number decreased from 6.8 ± 2.31 at the first year to 3.7 ± 3.64 at the fifth year. At the last visit, 48 (47.5%) eyes were being treated at an interval of ≥ 12 weeks or were under treatment cessation. Successful treatment cessation during the follow-up period and at the last visit were achieved in 56 (55.4%) and 27 (26.7%) eyes, with a median treatment-free period of 66 and 126 weeks, respectively. Good early treatment response and a small recurrence number were associated with successful treatment cessation at the last visit.Conclusion: Patients with good early response to treatment and fewer recurrences may achieve treatment cessation. This information could help physicians predict the achievement of treatment cessation for a considerable period.Keywords: age-related macular degeneration, pachychoroid neovasculopathy, anti-vascular endothelial growth factor, treat-and-extend regimen, treatment cessation