title: Treatment outcomes after 3 years in neovascular age-related macular degeneration using a treat-and-extend regimen.
abstract: OBJECTIVE
  To determine 3-year treatment outcomes after 1 to 3 years of ranibizumab or bevacizumab therapy using a treat-and-extend regimen in patients with neovascular age-related macular degeneration (AMD).
  
  
  METHODS
  Retrospective, interventional, consecutive case series.
  
  
  METHODS
  We treated 212 eyes from 196 patients diagnosed with treatment-naive neovascular AMD between January 2009 and March 2013; they were treated with either ranibizumab or bevacizumab for a minimum of 1 year, using a treat-and-extend regimen. The main outcome measures were change from baseline best-corrected Snellen visual acuity (BCVA), proportion of eyes losing <3 BCVA lines, proportion of eyes gaining ≥ 3 BCVA lines, change from baseline central retinal thickness, and mean number of injections at 1, 2 and 3 years of follow-up.
  
  
  RESULTS
  The mean follow-up period was 1.88 years (median, 2 years). At baseline, mean BCVA was 20/139; it improved to 20/79 (P < 0.001) after 1 year of treatment and was maintained at 20/69 and 20/64 at 2 and 3 years follow-up (P < 0.001), respectively. At baseline, mean central retinal thickness was 351 μm and significantly decreased to 285 μm, 275 μm and 276 μm at 1, 2 and 3 years of follow-up (P < 0.001), respectively. Patients received, on average, 7.6, 5.7 and 5.8 injections over years 1, 2 and 3 of treatment, respectively. At final follow-up, 94% of eyes had lost <3 lines BCVA, and 34.4% of eyes had gained ≥ 3 lines BCVA.
  
  
  CONCLUSIONS
  The treat-and-extend regimen is effective in achieving and maintaining visual and anatomic improvements in patients with neovascular AMD for up to 3 years of treatment.
authors.affiliation: Retina Service of Wills Eye Hospital, Mid-Atlantic Retina, Philadelphia, Pennsylvania.
authors.forename: Nadim
authors.initials: N
authors.lastname: Rayess
authors.affiliation: Retina Service of Wills Eye Hospital, Mid-Atlantic Retina, Philadelphia, Pennsylvania.
authors.forename: S K Steven
authors.initials: SK
authors.lastname: Houston
authors.affiliation: Retina Service of Wills Eye Hospital, Mid-Atlantic Retina, Philadelphia, Pennsylvania.
authors.forename: Omesh P
authors.initials: OP
authors.lastname: Gupta
authors.affiliation: Retina Service of Wills Eye Hospital, Mid-Atlantic Retina, Philadelphia, Pennsylvania.
authors.forename: Allen C
authors.initials: AC
authors.lastname: Ho
authors.affiliation: Retina Service of Wills Eye Hospital, Mid-Atlantic Retina, Philadelphia, Pennsylvania. Electronic address: cregillo@aol.com.
authors.forename: Carl D
authors.initials: CD
authors.lastname: Regillo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D000068258:Bevacizumab; D020256:Choroidal Neovascularization / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008268:Macular Degeneration / Q000188:drug therapy*; D008297:Male; D017063:Outcome Assessment, Health Care; D000069579:Ranibizumab; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D014792:Visual Acuity
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D000069579:Ranibizumab