Jennifer J Arnold1, Anna Campain2, Daniel Barthelmes3, Judy M Simpson4, Robyn H Guymer5, Alex P Hunyor6, Ian L McAllister7, Rohan W Essex8, Nigel Morlet9, Mark C Gillies1. 1. Marsden Eye Specialists, Parramatta, New South Wales, Australia. 2. The Save Sight Institute, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia. 3. The Save Sight Institute, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia; Department of Ophthalmology, University Hospital Zurich, University of Zurich, Zurich, Switzerland. Electronic address: daniel.barthelmes@usz.ch. 4. School of Public Health, University of Sydney, Sydney, New South Wales, Australia. 5. Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Victoria, Australia. 6. The Save Sight Institute, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia; Retina Associates, Chatswood, New South Wales, Australia. 7. Lions Eye Institute, Centre for Ophthalmology and Vision Science, University of Western Australia, Western Australia. 8. Academic Unit of Ophthalmology, Australian National University, Acton, Canberra, Australia. 9. University of Western Australia Department of Population Health, Perth, Western Australia.
Abstract
PURPOSE: To report 24-month outcomes of anti-vascular endothelial growth factor (VEGF) therapy for treatment-naïve eyes with neovascular age-related macular degeneration (nAMD) using a treat and extend treatment regimen in routine clinical practice. DESIGN: Database observational study. PARTICIPANTS: We included treatment-naïve eyes receiving predominantly ranibizumab for nAMD in routine clinical practice treated using a treat and extend regimen that were tracked in the Fight Retinal Blindness observational registry. METHODS: A cohort of eyes treated by practitioners using exclusively a treat and extend regimen was extracted from the Fight Retinal Blindness observational registry. MAIN OUTCOME MEASURES: Change in visual acuity (VA) over 2 years and number of injections and visits. RESULTS: Data from 1198 eyes from 1011 patients receiving anti-VEGF therapy using a treat and extend regimen for treatment-naïve nAMD between January 2007 and December 2012 and with 24-month follow-up were included in the analysis. Mean VA increased by +5.3 logarithm of the minimum angle of resolution letters from 56.5 letters (20/80+1) at initial visit to 61.8 (20/60+2) letters at 24 months. Mean VA gains improved and number of injections increased with successive years from +2.7 letters for eyes commencing in 2007 after a mean of 9.7 injections in 2 years, to +7.8 letters for eyes commencing in 2012 after a mean of 14.2 injections over 2 years. The proportion of eyes with VA >20/40 increased from 27% when starting treatment to 45% after 24 months; the proportion with vision of <20/200 remained unchanged (13% initial, 11% at 24 months). Of the included eyes, 90.5% avoided a vision loss of ≥15 letters. There was an overall mean of 13.0 injections over the 24 months, 7.5 injections in the first year and 5.5 in the second year, with a mean of 14.8 clinic visits. CONCLUSIONS: These data indicate that eyes managed in routine clinical practice with a treat and extend regimen can achieve good visual outcomes while decreasing the burden of treatments and clinic visits.
PURPOSE: To report 24-month outcomes of anti-vascular endothelial growth factor (VEGF) therapy for treatment-naïve eyes with neovascular age-related macular degeneration (nAMD) using a treat and extend treatment regimen in routine clinical practice. DESIGN: Database observational study. PARTICIPANTS: We included treatment-naïve eyes receiving predominantly ranibizumab for nAMD in routine clinical practice treated using a treat and extend regimen that were tracked in the Fight Retinal Blindness observational registry. METHODS: A cohort of eyes treated by practitioners using exclusively a treat and extend regimen was extracted from the Fight Retinal Blindness observational registry. MAIN OUTCOME MEASURES: Change in visual acuity (VA) over 2 years and number of injections and visits. RESULTS: Data from 1198 eyes from 1011 patients receiving anti-VEGF therapy using a treat and extend regimen for treatment-naïve nAMD between January 2007 and December 2012 and with 24-month follow-up were included in the analysis. Mean VA increased by +5.3 logarithm of the minimum angle of resolution letters from 56.5 letters (20/80+1) at initial visit to 61.8 (20/60+2) letters at 24 months. Mean VA gains improved and number of injections increased with successive years from +2.7 letters for eyes commencing in 2007 after a mean of 9.7 injections in 2 years, to +7.8 letters for eyes commencing in 2012 after a mean of 14.2 injections over 2 years. The proportion of eyes with VA >20/40 increased from 27% when starting treatment to 45% after 24 months; the proportion with vision of <20/200 remained unchanged (13% initial, 11% at 24 months). Of the included eyes, 90.5% avoided a vision loss of ≥15 letters. There was an overall mean of 13.0 injections over the 24 months, 7.5 injections in the first year and 5.5 in the second year, with a mean of 14.8 clinic visits. CONCLUSIONS: These data indicate that eyes managed in routine clinical practice with a treat and extend regimen can achieve good visual outcomes while decreasing the burden of treatments and clinic visits.
Authors: Aaron Y Lee; Cecilia S Lee; Catherine A Egan; Clare Bailey; Robert L Johnston; Salim Natha; Robin Hamilton; Rehna Khan; Sahar Al-Husainy; Christopher Brand; Toks Akerele; Martin Mckibbin; Louise Downey; Adnan Tufail Journal: Br J Ophthalmol Date: 2017-05-06 Impact factor: 4.638
Authors: Daniel Barthelmes; Vuong Nguyen; Richard Walton; Mark C Gillies; Vincent Daien Journal: Graefes Arch Clin Exp Ophthalmol Date: 2018-07-27 Impact factor: 3.117
Authors: Ian L McAllister; Lynne A Smithies; Fred K Chen; David A Mackey; Paul G Sanfilippo Journal: JAMA Ophthalmol Date: 2018-12-01 Impact factor: 7.389
Authors: G Liew; A Y Lee; J Zarranz-Ventura; I Stratton; C Bunce; U Chakravarthy; C S Lee; P A Keane; D A Sim; T Akerele; M McKibbin; L Downey; S Natha; C Bailey; R Khan; R Antcliff; S Armstrong; A Varma; V Kumar; M Tsaloumas; K Mandal; C Egan; R L Johnston; A Tufail Journal: Eye (Lond) Date: 2016-07-15 Impact factor: 3.775