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An 8‐year follow‐up of anti‐vascular endothelial growth factor treatment with a treat‐and‐extend modality for neovascular age‐related macular degeneration
Author(s) -
Berg Karina,
Roald Anca B.,
Navaratnam Jesintha,
Bragadóttir Ragnheiður
Publication year - 2017
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/aos.13522
Subject(s) - medicine , macular degeneration , ophthalmology , bevacizumab , visual acuity , ranibizumab , diabetic retinopathy , regimen , choroidal neovascularization , surgery , diabetes mellitus , chemotherapy , endocrinology
Purpose To investigate long‐term visual results of treatment with anti‐vascular endothelial growth factor ( VEGF ) agents for neovascular age‐related macular degeneration ( nAMD ) following a treat‐and‐extend regimen. Methods Retrospective review of 155 patients who initiated treatment with bevacizumab for nAMD in one eye. At the final 8‐year visit, 40 patients (26%) remained for follow‐up. Mean change in best‐corrected visual acuity ( BCVA ) was calculated compared to baseline values. Results Mean BCVA improved significantly from baseline during the first year of treatment, with −0.11 log MAR units equivalent to 6.1 approximate Early Treatment Diabetic Retinopathy Study (approx ETDRS ) letters (p = <0.001). Mean BCVA was still significantly improved after 4 years of treatment for the entire group of patients and after 6 years of treatment for the subgroup of 40 patients who remained at the final 8‐year visit. Thereafter, BCVA gradually declined and at 8 years, there was a mean change of 0.05 log MAR units equivalent to 2.1 approx ETDRS letters below baseline (p = 0.530). Mean number of injections during the first year was 6.1 ± 2.8 and during year 8 was 5.4 ± 3.5. At 5 years, fundus autofluorescence showed some degree of macular atrophy in all eyes. At the final 8‐year visit, 87.5% of the eyes had stable neovascular lesions with no fluid on optical coherence tomography (OCT). Conclusion In an everyday clinical setting, treatment of nAMD patients with a treat‐and‐extend modality provided improvement and stability of vision for several years. After 8 years of follow‐up, there was a decline in visual acuity (VA) that could be explained by macular atrophic development.