Four-year outcome of aflibercept administration using a treat-and-extend regimen in eyes with recurrent neovascular age-related macular degeneration.

Abstract

To investigate the 4-year outcome of aflibercept treatment using a treat-and-extend (TAE) regimen for recurrent neovascular age-related macular degeneration (AMD). Retrospective observational study. Data of eyes with recurrent AMD previously treated with anti-vascular endothelial growth factor agents or photodynamic therapy and had started aflibercept treatment using a TAE regimen for the first time were collected. Best-corrected visual acuity (BCVA), intervals of treatments, the presence of exudation, central foveal thickness (CFT), and central choroidal thickness (CCT) were analyzed. Of 47 consecutive eyes, 30 of the 47 eyes completed a 4-year follow-up. The mean BCVA (logMAR) was sustained over the 4years (0.37 at baseline, 0.36 at 1year, 0.36 at 2years, 0.41 at 3years, and 0.43 at 4years, P = 0.21). Of the 30 eyes that completed the follow-up, BCVA of two eyes deteriorated by 0.3 logMAR or more at 4years. At 4years, 67% of eyes had extended treatment intervals to > 8weeks, and 47% of eyes had extended intervals to > 12weeks. Exudative changes in the macula, seen in all eyes at baseline, were only seen in 50% of the eyes at 4years. The mean CFT and CCT decreased significantly at 4years from 332μm to 248μm and from 218μm to 183μm, respectively. In clinical settings, aflibercept treatment using a TAE regimen may successfully maintain visual acuity for up to 4years even in recurrent cases of AMD.