title: A modified treat-and-extend regimen of aflibercept for treatment-naïve patients with neovascular age-related macular degeneration.
abstract: OBJECTIVE
  To evaluate a modified treat-and-extend (TAE) regimen of intravitreal aflibercept injection (IAI) for treatment-naïve patients with neovascular age-related macular degeneration (AMD).
  
  
  METHODS
  Thirty-six eyes (36 patients) treated with the modified TAE regimen were evaluated at 12 months retrospectively. The modified TAE regimen consisted of three steps: 1) an induction phase, during which patients were treated with ≥ 3-monthly IAIs until exudative activity disappeared, 2) an observation phase, during which patients were monitored until exudative activity appeared, and 3) a TAE phase, for which the initial treatment interval was determined based on the disease recurrence interval, followed by treatment intervals changing by 2 weeks.
  
  
  RESULTS
  Mean logMAR BCVA improved significantly from 0.48 ± 0.51 at baseline to 0.40 ± 0.53 at 12 months (P < 0.01), and was maintained (losing <0.3 logMAR units) in 35 eyes (97.2 %). Mean central retinal thickness and central choroidal thickness decreased significantly after 12 months. In the TAE phase, the distribution of treatment intervals was ≥8 weeks in 64.7 % (11 eyes) at 12 months. The mean number of injections was 4.53.
  
  
  CONCLUSIONS
  A modified TAE regimen of IAI for neovascular AMD produced good functional outcomes over 12 months with the small number of injections.
authors.affiliation: Department of Ophthalmology, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka, 573-1010, Japan. ohnakam@hirakata.kmu.ac.jp.
authors.forename: Masayuki
authors.identifier: http://orcid.org/0000-0001-9187-8887
authors.initials: M
authors.lastname: Ohnaka
authors.affiliation: Department of Ophthalmology, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka, 573-1010, Japan.
authors.forename: Yoshimi
authors.initials: Y
authors.lastname: Nagai
authors.affiliation: Department of Ophthalmology, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka, 573-1010, Japan.
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Sho
authors.affiliation: Department of Ophthalmology, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka, 573-1010, Japan.
authors.forename: Katsuaki
authors.initials: K
authors.lastname: Miki
authors.affiliation: Department of Ophthalmology, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka, 573-1010, Japan.
authors.forename: Motoki
authors.initials: M
authors.lastname: Kimura
authors.affiliation: Department of Ophthalmology, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka, 573-1010, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Chihara
authors.affiliation: Department of Ophthalmology, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka, 573-1010, Japan.
authors.forename: Kanji
authors.initials: K
authors.lastname: Takahashi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002829:Choroid / Q000473:pathology; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D005654:Fundus Oculi; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D008875:Middle Aged; D040262:Receptors, Vascular Endothelial Growth Factor / Q000008:administration & dosage* / Q000037:antagonists & inhibitors; D011993:Recombinant Fusion Proteins / Q000008:administration & dosage*; D012160:Retina / Q000473:pathology; D012189:Retrospective Studies; D013997:Time Factors; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology*; D057135:Wet Macular Degeneration / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology
chemical_list: D011993:Recombinant Fusion Proteins; C533178:aflibercept; D040262:Receptors, Vascular Endothelial Growth Factor
keywords: Aflibercept; Anti-vascular endothelial growth factor; Neovascular age-related macular degeneration; Pro re nata dosing regimen; Treat-and-extend regimen; Treatment-naïve patients