Alaa Din Abdin1, Shady Suffo2, Fatima Asi2, Achim Langenbucher3, Berthold Seitz2. 1. Department of Ophthalmology, Saarland University Medical Center UKS, KirrbergerStrasse 100, Bldg. 22, 66421, Homburg, Saar, Germany. alaadin.abdin@uks.eu. 2. Department of Ophthalmology, Saarland University Medical Center UKS, KirrbergerStrasse 100, Bldg. 22, 66421, Homburg, Saar, Germany. 3. Institute of Experimental Ophthalmology, Saarland University, Homburg, Saar, Germany.
Abstract
PURPOSE: To assess the morphological and functional outcome and stability of the "treat and extend" protocol using aflibercept compared to ranibizumab for the treatment of eyes with neovascular age-related macular degeneration. PATIENTS AND METHODS: This retrospective study included 100 eyes of 94 patients with primary onset neovascular age-related macular degeneration followed up for 12 months. We studied two groups of eyes: group 1, 50 eyes treated with 0.5 mg/0.05 mL ranibizumab and group 2, 50 eyes treated with 2.0 mg/0.05 mL aflibercept. During the first year, all eyes received 3 aflibercept or ranibizumab injections monthly as upload phase. Then, eyes were treated with a treat and extend algorithm. Main outcome measures included: best corrected visual acuity (BCVA), central macular thickness (CMT), and the number of injections. In addition, we compared recurrence rates between the two groups. RESULTS: BCVA (log MAR) in group 1 vs group 2 was 0.54 ± 0.31 vs 0.49 ± 0.30 (p = 0.38) before treatment and 0.49 ± 0.33 vs 0.47 ± 0.32 (p = 0.85) after treatment. The visual improvement (decimal) was 0.05 ± 0.13 vs 0.04 ± 0.12 (p = 0.91). CMT in group 1 vs group 2 was 375.6 ± 98.3 μm vs 369.6 ± 103.7 μm (p = 0.73) before treatment and 306.3 ± 71.8 μm vs 294.8 ± 96 μm (p = 0.54) after treatment. The decrease in CMT was 69.3 ± 93 μm vs 74.8 ± 96 μm (p = 0.77). The number of injections/eye after upload phase in group 1 vs group 2 was 5.88 ± 1.4 vs 6.16 ± 1.3 (p = 0.25). Finally, major recurrence rates were statistically significantly different between the two groups (2% vs 6%, p = 0.04). CONCLUSIONS: Significant differences regarding BCVA, central macular thickness, and the number of injections were not found between aflibercept and ranibizumab during the first year following the treat and extend protocol. However, the significantly higher major recurrence rates in the aflibercept group after extending the treatment interval to 10 weeks might suggest that aflibercept should better not to be used in longer than 8 weeks intervals during the first year of treatment.
PURPOSE: To assess the morphological and functional outcome and stability of the "treat and extend" protocol using aflibercept compared to ranibizumab for the treatment of eyes with neovascular age-related macular degeneration. PATIENTS AND METHODS: This retrospective study included 100 eyes of 94 patients with primary onset neovascular age-related macular degeneration followed up for 12 months. We studied two groups of eyes: group 1, 50 eyes treated with 0.5 mg/0.05 mL ranibizumab and group 2, 50 eyes treated with 2.0 mg/0.05 mL aflibercept. During the first year, all eyes received 3 aflibercept or ranibizumab injections monthly as upload phase. Then, eyes were treated with a treat and extend algorithm. Main outcome measures included: best corrected visual acuity (BCVA), central macular thickness (CMT), and the number of injections. In addition, we compared recurrence rates between the two groups. RESULTS:BCVA (log MAR) in group 1 vs group 2 was 0.54 ± 0.31 vs 0.49 ± 0.30 (p = 0.38) before treatment and 0.49 ± 0.33 vs 0.47 ± 0.32 (p = 0.85) after treatment. The visual improvement (decimal) was 0.05 ± 0.13 vs 0.04 ± 0.12 (p = 0.91). CMT in group 1 vs group 2 was 375.6 ± 98.3 μm vs 369.6 ± 103.7 μm (p = 0.73) before treatment and 306.3 ± 71.8 μm vs 294.8 ± 96 μm (p = 0.54) after treatment. The decrease in CMT was 69.3 ± 93 μm vs 74.8 ± 96 μm (p = 0.77). The number of injections/eye after upload phase in group 1 vs group 2 was 5.88 ± 1.4 vs 6.16 ± 1.3 (p = 0.25). Finally, major recurrence rates were statistically significantly different between the two groups (2% vs 6%, p = 0.04). CONCLUSIONS: Significant differences regarding BCVA, central macular thickness, and the number of injections were not found between aflibercept and ranibizumab during the first year following the treat and extend protocol. However, the significantly higher major recurrence rates in the aflibercept group after extending the treatment interval to 10 weeks might suggest that aflibercept should better not to be used in longer than 8 weeks intervals during the first year of treatment.
Entities:
Keywords:
Aflibercept; Neovascular age-related macular degeneration; Ranibizumab; Treat and extend
Authors: S W Quist; L A de Jong; F van Asten; P Knoester; M J Postma; R D Freriks Journal: Graefes Arch Clin Exp Ophthalmol Date: 2021-10-13 Impact factor: 3.117
Authors: Voraporn Chaikitmongkol; Min Sagong; Timothy Y Y Lai; Gavin S W Tan; Nor Fariza Ngah; Masahito Ohji; Paul Mitchell; Chang-Hao Yang; Paisan Ruamviboonsuk; Ian Wong; Taiji Sakamoto; Anand Rajendran; Youxin Chen; Dennis S C Lam; Chi-Chun Lai; Tien Yin Wong; Chui Ming Gemmy Cheung; Andrew Chang; Adrian Koh Journal: Asia Pac J Ophthalmol (Phila) Date: 2021-11-24