title: Long-Term Visual Outcomes for a Treat and Extend Anti-Vascular Endothelial Growth Factor Regimen in Eyes with Neovascular Age-Related Macular Degeneration.
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.
authors.affiliation: Vitreous, Retina, Macula Consultants of New York, New York, NY 10022, USA. sarahmrejen.uretsky@gmail.com.|LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear, and Throat Hospital, New York, NY 10065, USA. sarahmrejen.uretsky@gmail.com.|Quinze-Vingts Hospital, DHU ViewMaintain, INSERM-DHOS CIC 1423, 75012 Paris, France. sarahmrejen.uretsky@gmail.com.
authors.forename: Sarah
authors.initials: S
authors.lastname: Mrejen
authors.affiliation: Vitreous, Retina, Macula Consultants of New York, New York, NY 10022, USA. sucharita.boddu@med.nyu.edu.|LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear, and Throat Hospital, New York, NY 10065, USA. sucharita.boddu@med.nyu.edu.|Department of Ophthalmology, New York University School of medicine, New York, NY 10016 USA. sucharita.boddu@med.nyu.edu.|Edward S. Harkness Eye Institute Columbia, New York, NY 10032, USA. sucharita.boddu@med.nyu.edu.
authors.forename: Jesse J
authors.initials: JJ
authors.lastname: Jung
authors.affiliation: Department of Surgery, Monash University, Melbourne, VIC 3800, Australia. chris_chen30@hotmail.com.|Center for Eye Research Australia, University of Melbourne, East Melbourne, VIC 3002, Australia. chris_chen30@hotmail.com.
authors.forename: Christine
authors.initials: C
authors.lastname: Chen
authors.affiliation: Weill Cornell Medical College, New York, NY 10065, USA. snp2002@med.cornell.edu.
authors.forename: Samir N
authors.initials: SN
authors.lastname: Patel
authors.affiliation: Department of Ophthalmology, University and Polytechnic Hospital La Fe, 46026 Valencia, Spain. robertogallegopinazo@gmail.com.
authors.forename: Roberto
authors.initials: R
authors.lastname: Gallego-Pinazo
authors.affiliation: Weill Cornell Medical College, New York, NY 10065, USA. nicolas.yannuzzi@gmail.com.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Yannuzzi
authors.affiliation: The New York Eye and Ear Infirmary, New York, NY 10003, USA.
authors.forename: Luna
authors.initials: L
authors.lastname: Xu
authors.affiliation: Vitreous, Retina, Macula Consultants of New York, New York, NY 10022, USA. marcelamarsiglia@hotmail.com.|LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear, and Throat Hospital, New York, NY 10065, USA. marcelamarsiglia@hotmail.com.|Edward S. Harkness Eye Institute Columbia, New York, NY 10032, USA. marcelamarsiglia@hotmail.com.
authors.forename: Marcela
authors.initials: M
authors.lastname: Marsiglia
authors.affiliation: Department of Ophthalmology, New York University School of medicine, New York, NY 10016 USA. sucharita.boddu@med.nyu.edu.
authors.forename: Sucharita
authors.initials: S
authors.lastname: Boddu
authors.affiliation: Vitreous, Retina, Macula Consultants of New York, New York, NY 10022, USA. kbfnyf@aol.com.|LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear, and Throat Hospital, New York, NY 10065, USA. kbfnyf@aol.com.|Department of Ophthalmology, New York University School of medicine, New York, NY 10016 USA. kbfnyf@aol.com.
authors.forename: K Bailey
authors.initials: KB
authors.lastname: Freund
keywords: Treat and Extend Regimen; anatomical classification; choroidal neovascularization; fluorescein angiography classification; intravitreal anti-VEGF injections; neovascular age-related macular degeneration