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Treat And Extend- A Successful Approach To Decrease The Number Of Intravitreal Anti-VEGF Injections In Neovascular Age-related Macular Degeneration Without Compromising The Efficacy | 13294
Clinical Pharmacology & Biopharmaceutics
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The novel intravitreal anti-VEGF therapy has revolutionized treatment of neovascular age-related macular degeneration
(AMD). After promising outcomes of monthly injections reported by the ANCHOR (
ti-VEGF antibody for the treatment
of predominantly classic
oidal neovascularization in age-related macular degeneration) and MARINA (
occult trial of the
n the treatment of
ge-related macular degeneration) clinical
trials, many studies aimed to achieve the same efficacy with fewer injections. We conducted a prospective cohort study on 120
patients with choroidal neovascularisation (CNV) secondary to AMD. They were treated with three initial monthly ranibizumab
or bevacizumab injections. Monthly injections were continued until there was no CNV activity (loss of >5 letters, subretinal/
intraretinal fluid or persistent/recurrent retinal haemorrhage). Then the interval to the next visit was extended by two weeks to a
maximum of 12 weeks. In the presence of CNV activity, this interval was shortened by two weeks. Patients received an ant-VEGF
injection at each visit regardless of CNV activity. Mean baseline VA was 51.2?12.1 Early Treatment Diabetic Retinopathy Study
scores. Mean change in VA from baseline was +9.5?10.9 and +8.0?12.9 letters after 12 and 24 months with, on average, 8.6?1.1
injections in the first year and 5.6? 2.0 in the second year. After 12 and 24 months, 97.5% and 95.0% of patients lost <15 letters.
The ?Treat and Extend? protocol - with fewer injections and visits - delivered outcomes comparable to those of the ANCHOR and
Dr Farshad Abedi obtained his MD from Iran University of Medical Sciences, Tehran, Iran. He completed a Doctor of Medical Science (DMedSc)
in ophthalmology at the University of Melbourne, Australia in 2013. His research was focused on predictors of anti-VEGF treatment in neovascular
AMD. He currently works at St Vincent?s Hospital in Sydney, Australia.