Intravitreal ranibizumab for neovascular age­related macular degeneration with a Treat and Extend protocol: anatomical and functional results

Abstract

AbstractPurpose To evaluate the efficacy of the Treat andExtend regimen using intravitreal ranibizumab for neovascular age‐related macular degeneration (nAMD)Methods A retrospective single‐center study including naive nAMD patients confirmed with a fluorescein and indocyanine green angiography and a macular SD‐OCT. After 3 monthly intravitreal ranibizumab injections, the interval between two injections was sequentially extended or shortened by 2 weeks depending on the presence or the absence of exudative disease with a maximum of 12 weeks. At each visit, an ETDRS VA and a macular SD‐OCT were performed. The functional outcomes were the gain in VA and the proportion of patients gaining at least three lines. The anatomical outcome was central retinal thickness (CRT) on OCT. The secondary outcomes were the number of injections.Results 111 patients were followed for one year, and 66 of them for two years. At baseline, the median VA was 59 [45‐70] letters and the median CRT was 326 [271‐402] µm. The median VA gain was 9 [2‐17] letters after one year and 10 [2‐23] letters after two years. Almost 30% gained more than three lines after 1 year and 42% after 2 years. The median decrease in CRT was 80 [29‐161] µm and 100 [57‐151] µm after 1 and 2 years, respectively. The median number of injections was 9 [8‐10] after one year and 10 [2‐23] after 2 years.Conclusion A Tret and Extend regimen with ranibizumab provides good visual outcomes after 1 and 2 years of follow‐up and seems to be an efficient strategy for the treatment of nAMD.