The University of Sydney, Save Sight Institute, Discipline of Ophthalmology, Sydney Medical School, Sydney, New South Wales, Australia.
Gladesville Eye Specialists, Gladesville, New South Wales, Australia.
Clin Exp Ophthalmol. 2021 Aug;49(6):570-578. doi: 10.1111/ceo.13962. Epub 2021 Jul 14.
We assessed the proportion of eyes with neovascular age-related macular degeneration (nAMD) in routine clinical practice that reach ≥14 week treatment intervals and their outcomes.
We analysed data from the Fight Retinal Blindness! (FRB!) Project database, a prospectively designed registry of 'real-world' outcomes. Treatment-naive eyes starting vascular endothelial growth factor (VEGF) inhibitors for nAMD from 1st January 2006 were included. Eyes were defined to have reached the ≥14 week treatment interval if they received ≥2 consecutive injections at treatment intervals of ≥14 week but not exceeding 26 weeks. Outcomes were reported in a subgroup of eyes that had 12 months of follow-up from reaching this interval.
Of the 3907 treatment-naïve eyes that started treatment during the identified periods on a treat-and-extend regimen and received at least 8 injections over the first 2 years, 402 (10%) eyes received at least 2 consecutive injections at an interval of ≥14 week during their follow-up. Fifty-two percent of these eyes maintained vision to 12 months, however only 40% stayed at this interval and 25% of the lesions reactivated.
We found that only 10% of eyes with nAMD were extended beyond a 13-week injection interval and that over half had returned to a shorter interval by 12 months. Eyes that stayed at this extended treatment interval maintained stable vision. More data on the outcomes of eyes treated with intervals longer than 3 months are required to establish whether emerging VEGF inhibitors provide a more sustained effect than the currently available drugs.
我们评估了在常规临床实践中接受抗血管内皮生长因子（VEGF）治疗的新生血管性年龄相关性黄斑变性（nAMD）患者中，达到≥14 周治疗间隔的比例及其结局。
我们分析了 Fight Retinal Blindness!（FRB！）项目数据库中的数据，该数据库是一项前瞻性设计的“真实世界”结局登记研究。纳入从 2006 年 1 月 1 日开始接受 VEGF 抑制剂治疗的初治 nAMD 眼。如果患者接受≥2 次连续注射，且治疗间隔为≥14 周但不超过 26 周，则认为达到了≥14 周的治疗间隔。仅在达到该间隔后的 12 个月随访中报告结局。
在所确定的时间段内，3907 例初治患者接受了治疗和扩展方案的治疗，在最初 2 年内至少接受了 8 次注射，其中 402（10%）例眼在随访期间至少接受了 2 次连续的≥14 周间隔注射。这些眼 52%在 12 个月时保持视力，但只有 40%保持在该间隔，25%的病变再次激活。
我们发现，只有 10%的 nAMD 眼的注射间隔延长至 13 周以上，超过一半的眼在 12 个月时返回更短的间隔。保持在该扩展治疗间隔的眼保持稳定的视力。需要更多关于间隔超过 3 个月治疗的眼的结局数据，以确定新出现的 VEGF 抑制剂是否比目前可用的药物提供更持久的效果。
