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Prediction of individual need for retreatment with ranibizumab for exudative age-related macular degeneration: the results of a treatment regimen ?observe and plan?

Session Details

Session Title: AMD I

Session Date/Time: Thursday 26/09/2013 | 08:30-10:30

Paper Time: 09:18

Venue: Hall 1 (Level 2)

First Author: I.Mantel SWITZERLAND

Co Author(s):    C. Gianniou   S. Niderprim   A. Ambresin   -. -     

Abstract Details

Purpose:

The purpose of this study was to test an “observe and plan” regimen that applies a periodic, individualized retreatment plan up to 6 months and aims to optimize the chronic care management of neovascular age-related macular degeneration (nAMD) with anti-VEGF injections.

Setting:

Prospective interventional institutional case series

Methods:

Study Population: 104 consecutive patients (115 eyes) with treatment naive nAMD. Intervention: 3 monthly loading doses of ranibizumab, followed by monthly observation visits to determine the individual injection-recurrence interval. Retreatment series of (2-)3 injections with the same interval shortened by 2 weeks. Control visits (at least every 6 months) allowed for adjusting of the interval, in the attempt to keep the macula dry. Main outcome measures: changes in visual acuity (VA) and central retinal thickness (CRT), number of injections and visits, and direct medical costs after 12 months.

Results:

100%, 58% and 14% of patients have completed the 12, 18 and 24 months follow-up respectively. Mean VA improved by 8.1 and 10.2 letters by months 3 and 12, respectively. The proportion of eyes that lost fewer than 3 lines was 98%, and 32% improved by 3 lines or more by month 12. The mean CRT change was -99 micrometers by month 12. The mean number of visits after baseline was 3.97, and the mean number of injections was 7.79. The mean treatment interval after the loading dose was 2.09 months. The mean cost was USD 18 709 per patient.

Conclusions:

Observe and Plan regimen allows significant visual improvement greatly reduced number of visits. This may increase the capacity of institutions to cope with the burden of nAMD.

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