PURPOSE: To evaluate the visual outcomes, number of injections, and direct medical cost of a treat-and-extend regimen in managing neovascular age-related macular degeneration with intravitreal bevacizumab. DESIGN: Retrospective, interventional, consecutive case series. METHODS: Seventy-four eyes of 73 patients with treatment-naïve neovascular age-related macular degeneration from a single clinical practice were treated monthly with intravitreal bevacizumab until no intraretinal or subretinal fluid was observed on optical coherence tomography. The treatment intervals then were lengthened sequentially by 2 weeks until signs of exudation recurred and then were reduced accordingly to maintain an exudation-free macula. Main outcomes measured included mean change from baseline visual acuity, proportion of eyes losing fewer than 3 and gaining 3 or more Snellen visual acuity lines at 1 year of follow-up, annual mean number of injections, optical coherence tomography mean central retinal thickness change from baseline, mean maximum period of extension, adverse events, and mean direct annual medical cost. RESULTS: The mean follow-up period was 1.41 years. Mean Snellen visual acuity improved from 20/230 at baseline to 20/109 at 12 months (P < .001) and 20/106 at 24 months (P < .001). The mean number of injections over the first year was 7.94. The mean optical coherence tomography central retinal thickness decreased from 316 to 239 μm at 12 months (P < .001). The mean direct medical cost over the first year was $3493.85. CONCLUSIONS: Eyes with neovascular age-related macular degeneration experienced significant visual improvements on average when managed with intravitreal bevacizumab using a treat-and-extend regimen with fewer patient visits and injections along with lower costs compared with a fixed, monthly dosing regimen. Copyright Â
PURPOSE: To evaluate the visual outcomes, number of injections, and direct medical cost of a treat-and-extend regimen in managing neovascular age-related macular degeneration with intravitreal bevacizumab. DESIGN: Retrospective, interventional, consecutive case series. METHODS: Seventy-four eyes of 73 patients with treatment-naïve neovascular age-related macular degeneration from a single clinical practice were treated monthly with intravitreal bevacizumab until no intraretinal or subretinal fluid was observed on optical coherence tomography. The treatment intervals then were lengthened sequentially by 2 weeks until signs of exudation recurred and then were reduced accordingly to maintain an exudation-free macula. Main outcomes measured included mean change from baseline visual acuity, proportion of eyes losing fewer than 3 and gaining 3 or more Snellen visual acuity lines at 1 year of follow-up, annual mean number of injections, optical coherence tomography mean central retinal thickness change from baseline, mean maximum period of extension, adverse events, and mean direct annual medical cost. RESULTS: The mean follow-up period was 1.41 years. Mean Snellen visual acuity improved from 20/230 at baseline to 20/109 at 12 months (P < .001) and 20/106 at 24 months (P < .001). The mean number of injections over the first year was 7.94. The mean optical coherence tomography central retinal thickness decreased from 316 to 239 μm at 12 months (P < .001). The mean direct medical cost over the first year was $3493.85. CONCLUSIONS: Eyes with neovascular age-related macular degeneration experienced significant visual improvements on average when managed with intravitreal bevacizumab using a treat-and-extend regimen with fewer patient visits and injections along with lower costs compared with a fixed, monthly dosing regimen. Copyright Â
Authors: Haiyan Wang; Giulio Barteselli; William R Freeman; Su Na Lee; Jay Chhablani; Sharif El-Emam; Lingyun Cheng Journal: Int J Ophthalmol Date: 2013-10-18 Impact factor: 1.779
Authors: W M Amoaku; U Chakravarthy; R Gale; M Gavin; F Ghanchi; J Gibson; S Harding; R L Johnston; S P Kelly; S Kelly; A Lotery; S Mahmood; G Menon; S Sivaprasad; J Talks; A Tufail; Y Yang Journal: Eye (Lond) Date: 2015-04-17 Impact factor: 3.775