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Graefe's Archive for Clinical and Experimental Ophthalmology

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03.02.2023 | Retinal Disorders

Seven-year outcome after 1-year fixed regimen of intravitreal aflibercept injections followed by pro re nata treatment for neovascular age-related macular degeneration

verfasst von: Yuki Hama, Manabu Miyata, Sotaro Ooto, Hiroshi Tamura, Naoko Ueda-Arakawa, Yuki Muraoka, Masahiro Miyake, Ayako Takahashi, Tomotaka Wakazono, Akihito Uji, Kenji Yamashiro, Akitaka Tsujikawa

Erschienen in: Graefe's Archive for Clinical and Experimental Ophthalmology | Ausgabe 7/2023

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Abstract

Purpose

The study aims to investigate the 7-year best-corrected visual acuity (BCVA) course after 1-year fixed regimen of intravitreal aflibercept injection (IVA) for neovascular age-related macular degeneration (nAMD) and to identify factors affecting this BCVA.

Methods

This longitudinal, observational study included 63 treatment-naïve eyes (61 patients) with nAMD, treated with 1-year fixed regimen of IVA—3 monthly injections and 4 subsequent bimonthly injections—essentially followed by PRN regimen of IVA but sometimes followed by agent switching, photodynamic therapy (PDT), or vitrectomy, as needed. We assessed BCVA changes over a 7-year period. Morphologically, we assessed central retinal thickness (CRT), central choroidal thickness (CCT), subfoveal pigment epithelial detachment (PED) height, vitreomacular traction/adhesion (VMT/VMA), epiretinal membrane (ERM), and macular atrophy involving the fovea.

Results

Logarithm of the minimum angle of resolution (logMAR) BCVA changed from 0.20 ± 0.24 to 0.29 ± 0.45 over 7 years. BCVA improved significantly after years 1 and 2 (P = 0.002 and 0.001, respectively) and then slowly decreased. BCVA after years 3–7 did not significantly differ from baseline. CRT and CCT decreased significantly during follow-up, while PED height did not. VMT/VMA decreased significantly, whereas ERM and macular atrophy increased significantly. Seven-year and baseline BCVA positively correlated (P = 0.007, β = 0.35).

Conclusions

BCVA was maintained for 7 years in nAMD eyes after 1-year fixed regimen of IVA, essentially followed by PRN regimen, but sometimes followed by agent switching, PDT, or vitrectomy, without severe drug-induced complications. Thus, early diagnosis and treatment of nAMD are essential for maintaining good long-term BCVA, even in eyes with relatively poor baseline vision.

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Titel: Seven-year outcome after 1-year fixed regimen of intravitreal aflibercept injections followed by pro re nata treatment for neovascular age-related macular degeneration
verfasst von: Yuki Hama
Manabu Miyata
Sotaro Ooto
Hiroshi Tamura
Naoko Ueda-Arakawa
Yuki Muraoka
Masahiro Miyake
Ayako Takahashi
Tomotaka Wakazono
Akihito Uji
Kenji Yamashiro
Akitaka Tsujikawa
Publikationsdatum: 03.02.2023
Verlag: Springer Berlin Heidelberg
Erschienen in: Graefe's Archive for Clinical and Experimental Ophthalmology / Ausgabe 7/2023
Print ISSN: 0721-832X
Elektronische ISSN: 1435-702X
DOI: https://doi.org/10.1007/s00417-023-05982-w

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Seven-year outcome after 1-year fixed regimen of intravitreal aflibercept injections followed by pro re nata treatment for neovascular age-related macular degeneration

Abstract

Purpose

Methods

Results

Conclusions

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