Extended (Every 12 Weeks or Longer) Dosing Interval With Intravitreal Aflibercept and Ranibizumab in Neovascular Age-Related Macular Degeneration: Post Hoc Analysis of VIEW Trials

PURPOSE: To evaluate outcomes and disease characteristics in eyes with neovascular age-related macular degeneration that received intravitreal aflibercept injection (IAI) and ranibizumab every 12 weeks or longer (>= q12 weeks) or less than every 12 weeks (< q12 weeks) during year 2 of VIEW studies. DESIGN: Post hoc analysis of randomized clinical trial data. METHODS: In year 1, eyes received ranibizumab q4 weeks (Rq4), IAI 2 mg q4 weeks (2q4), or IAI 2 mg q8 weeks after 3 monthly injections (2q8). In year 2, eyes received pro re nata treatment, with mandatory treatment at least q12 weeks. RESULTS: At week 96, 218 (42.5%), 284 (53.9%), and 245 (47.9%) eyes treated with Rq4, 2q4, and 2q8, respectively, received treatment at >= q12-week intervals and 295 (57.5%), 243 (46.1%), and 266 (52.1%) eyes at < 12q-week intervals during the second year. Baseline occult-type choroidal neovascularization (CNV) (P = .0156) and retinal fluid (P < .0001) and leakage (P < .0001) at week 52 were associated with < q12-week dosing. Mean best-corrected visual acuity gains from baseline with Rq4, 2q4, and 2q8 at >= q12-week interval were 8.7, 9.9, and 9.7 letters at week 52 and 8.5, 8.8, and 9.2 letters at week 96, respectively. The corresponding gains with < q12-week dosing were 10.3, 9.7, and 8.9 letters at week 52 and 9.1, 7.7, and 8.1 letters at week 96. CONCLUSIONS: Baseline CNV type other than occult and absence of retinal fluid and leakage at week 52 were significantly associated with >= q12-week dosing. Vision improvements at week 52 following a year of fixed dosing with ranibizumab and IAI were maintained at week 96 in eyes that received treatment >= q12 weeks and < q12 weeks. (C) 2019 Elsevier Inc. All rights reserved.