AMD patients on an extended treatment interval of 12 weeks achieved similar visual acuity to those with a more intensive regimen. Photo: Leonid Skorin Jr., DO, OD, MS. Click image to enlarge.

Patients with neovascular age-related macular degeneration (wet AMD) can be treated with anti-VEGF intravitreal injections using individualized treat-and-extend regimens. Understanding the proportion of patients able to achieve a longer treatment interval of 12 weeks (q12) in real-world practice is particularly important when planning the high-volume delivery of these injections. A study recently found that 68% of eyes were able to achieve an extended treatment interval of 12 weeks with aflibercept for wet AMD in the first two years of treatment and that these patients appeared to have a similar visual acuity outcome compared with those who required a more intensive treatment regimen.

The retrospective, comparative, non-randomized EMR database study assessed 2,416 eyes of 2,163 patients with wet AMD who had received at least seven aflibercept intravitreal injections. Of the eyes, 68% had at least one q12 dosing interval (≥84 and ≤98 days between injections) during the first two years of treatment. The median time until a patient achieved q12 dosing after beginning treatment was 1.76 years, with a median number of 10 injections. The mean number of intravitreal injections in patients who achieved and did not achieve a q12 intravitreal injection treatment was 13.8 and 16.9 at 24 months, respectively.

Both the mean visual acuity outcome and the proportion of patients maintaining good visual acuity of >70 ETDRS letters (approximately 6/12 or better on the Snellen scale) at 24 months were similar between groups, despite a lower number of injections in the q12 group. “As those achieving at least one q12 interval require fewer injections, this might suggest that these patients are more stable in terms of their disease activity,” the authors concluded in their paper in Eye.

Fu DF, Hanumunthadu D, Keenan TDL, et al. Characterizing treatment outcomes of patients achieving quarterly aflibercept dosing for neovascular age-related macular degeneration: real-world clinical outcomes from a large tertiary care center. Eye (Lond). September 9, 2022. [Epub ahead of print].