Author(s):
Providência, Joana ; Rodrigues, Tiago M ; Oliveira, Mariana ; Bernardes, João ; Marques, João Pedro ; Murta, Joaquim N. ; Silva, Rufino
Date: 2018
Persistent ID: https://hdl.handle.net/10316/107513
Origin: Estudo Geral - Universidade de Coimbra
Subject(s): Aged; Aged, 80 and over; Angiogenesis Inhibitors; Female; Follow-Up Studies; Humans; Intravitreal Injections; Macular Degeneration; Male; Ranibizumab; Receptors, Vascular Endothelial Growth Factor; Recombinant Fusion Proteins; Retrospective Studies; Tomography, Optical Coherence; Treatment Outcome; Visual Acuity
Description
Intravitreal injections of antivascular endothelial growth factors have been considered a milestone in the treatment of neovascular age-related macular degeneration (nAMD). However, the increasing incidence of AMD and the burden of visits and injections overcharge both the patient and the healthcare systems. Real-world solutions depend on treatment protocols aimed at optimizing the number of clinical visits while guaranteeing good functional outcomes. We performed a retrospective analysis of 72 eyes from 63 naïve patients diagnosed with nAMD that underwent a fixed intravitreal protocol consisting of bimonthly injections after a three-month loading dose, with either Aflibercept or Ranibizumab (no predefined criteria for treatment selection). Best corrected visual acuity (BCVA) and optical coherence tomography were analyzed at baseline and during follow-up clinical visits (months 3, 6, 12, and 18). From the included participants, 42 followed a fixed regimen with Aflibercept and 30 with Ranibizumab. At the 12-month visit, there was not a statistically significant difference in the mean change of BCVA between the two groups (p=0.121); however, the mean difference in the central retinal thickness was significantly superior in the Aflibercept group (-142.2 versus -51.5, p=0.011). The described fixed regimen seems to be efficient in the treatment of nAMD in a clinical practice setting.
