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J. Clin. Med. 2015, 4(7), 1380-1402; doi:10.3390/jcm4071380

Long-Term Visual Outcomes for a Treat and Extend Anti-Vascular Endothelial Growth Factor Regimen in Eyes with Neovascular Age-Related Macular Degeneration

1
Vitreous, Retina, Macula Consultants of New York, New York, NY 10022, USA
2
LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear, and Throat Hospital, New York, NY 10065, USA
3
Quinze-Vingts Hospital, DHU ViewMaintain, INSERM-DHOS CIC 1423, 75012 Paris, France
4
Department of Ophthalmology, New York University School of medicine, New York, NY 10016 USA
5
Edward S. Harkness Eye Institute Columbia, New York, NY 10032, USA
6
Department of Surgery, Monash University, Melbourne, VIC 3800, Australia
7
Center for Eye Research Australia, University of Melbourne, East Melbourne, VIC 3002, Australia
8
Weill Cornell Medical College, New York, NY 10065, USA
9
Department of Ophthalmology, University and Polytechnic Hospital La Fe, 46026 Valencia, Spain
10
The New York Eye and Ear Infirmary, New York, NY 10003, USA
*
Author to whom correspondence should be addressed.
Academic Editors: Lindsay Farrer and Margaret DeAngelis
Received: 5 April 2015 / Revised: 22 June 2015 / Accepted: 26 June 2015 / Published: 8 July 2015
(This article belongs to the Special Issue Age-Related Macular Disease)
View Full-Text   |   Download PDF [714 KB, uploaded 14 July 2015]   |  

Abstract

With the advent of anti-vascular endothelial growth factor (VEGF) therapy, clinicians are now focused on various treatment strategies to better control neovascular age-related macular degeneration (NVAMD), a leading cause of irreversible blindness. Herein, we retrospectively reviewed consecutive patients with treatment-naïve NVAMD initially classified based on fluorescein angiography (FA) alone or with an anatomic classification utilizing both FA and optical coherence tomography (OCT) and correlated long-term visual outcomes of these patients treated with an anti-VEGF Treat-and-Extend Regimen (TER) with baseline characteristics including neovascular phenotype. Overall, 185 patients (210 eyes) were followed over an average of 3.5 years (range 1–6.6) with a retention rate of 62.9%, and visual acuity significantly improved with a TER that required a mean number of 8.3 (±1.6) (± standard deviation) intravitreal anti-VEGF injections/year (range 4–13). The number of injections and the anatomic classification were independent predictors of visual acuity at 6 months, 1, 2, 3 and 4 years. Patients with Type 1 neovascularization had better visual outcomes and received more injections than the other neovascular subtypes. There were no serious adverse events. A TER provided sustained long-term visual gains. Eyes with Type 1 neovascularization had better visual outcomes than those with other neovascular subtypes. View Full-Text
Keywords: anatomical classification; choroidal neovascularization; fluorescein angiography classification; intravitreal anti-VEGF injections; neovascular age-related macular degeneration; Treat and Extend Regimen anatomical classification; choroidal neovascularization; fluorescein angiography classification; intravitreal anti-VEGF injections; neovascular age-related macular degeneration; Treat and Extend Regimen
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

Mrejen, S.; Jung, J.J.; Chen, C.; Patel, S.N.; Gallego-Pinazo, R.; Yannuzzi, N.; Xu, L.; Marsiglia, M.; Boddu, S.; Freund, K.B. Long-Term Visual Outcomes for a Treat and Extend Anti-Vascular Endothelial Growth Factor Regimen in Eyes with Neovascular Age-Related Macular Degeneration. J. Clin. Med. 2015, 4, 1380-1402.

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