First Author: M.Falcão PORTUGAL
Co Author(s): D. Rodrigues C. Pedrosa J. Esteves J. Pinheiro-Costa A. Carneiro F. Falcao-Reis
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Treat and extend regimens (TE), in patients receiving intravitreal anti-vascular endothelial growth factor injections for age-related macular degeneration, have the potential to preserve patient’s visual acuity and to reduce patient’s visits. In our study, we aimed to analyze if a modified TE regimen, applied years after a pro re nata (PRN) regimen, leads to improvements in best corrected visual acuity (BCVA) and anatomical parameters, and to decreases in the number of injections and follow-up visits
Ophthalmology Department of Centro Hospitalar de São João
Retrospective, case series of patients who were initially treated with a PRN regimen for at least 2 years (average was 6.4±1.0 years), and who were switched to a modified TE regimen, which they maintained for at least one additional year (45 completed two years). In this modified TE and regimen, once the injection interval for each patient was determined, injections could occur without other ophthalmic evaluation procedures).
58 treatment-naïve eyes from 58 patients were included. During the first year of PRN, mean BCVA significantly increased from 52.67±18.32 to 59.69±14.11 (p<0.001). During the second year of PRN, the mean BCVA significantly decreased to 57.12±15.94 (p=0.030). There was no significant change in the mean BCVA during the TE years. Mean central retinal thickness (CRT) tended to decrease over time, except in the last year of TE where there was non-significant increase. Changes in CRT were only significant during the first year of PRN (262.57±133.11 µm to 206.79±86.68µm; p=0.01) and during the first year of TE (171.23±65.94µm to 159.68±55.19µm; p=0.035). The mean number of injections per patient during the first and second years of TE (8.07±2.24 and 8.80±2.33) was significantly higher than in the first and second years of PRN (6.02±2.56 and 5.26±2.77, p<0.001), while the mean number of visits was significantly lower in the TE years (p<0.001).
The modified TE regimen maintained the patients’ BCVA after switching from a PRN regimen for 24 months. The follow-up ophthalmological visits required during the modified TE schedule were significantly lower, however, the number of injections given was significantly higher when compared with the PRN regimen due to injections without simultaneous ophthalmic evaluation.