4.4 Article

LONG-TERM MORPHOLOGIC CHANGES IN MACULAR NEOVASCULARIZATION UNDER AFLIBERCEPT TREATMENT WITH A TREAT-AND-EXTEND REGIMEN

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LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/IAE.0000000000003676

Keywords

age-related macular degeneration; OCT angiography; choroidal neovascularization; macular neovascularization

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This study aimed to examine the morphologic changes in macular neovascularization (MNV) secondary to age-related macular degeneration after 2 years of aflibercept treatment under a treat-and-extend (T&E) regimen. The medical records of 26 eyes of 25 patients with treatment-naive neovascular age-related macular degeneration were analyzed retrospectively, and these patients were treated with aflibercept under a treat-and-extend regimen for 2 years. Swept-source optical coherence tomography angiography was used to assess the areas of the MNV and vascular structures at baseline and after 2 years of treatment. The results showed that the MNV area increased significantly after 2 years of treatment, and the baseline MNV area was negatively correlated with the change ratio of the MNV areas at 2 years and baseline.
Purpose:To examine the morphologic changes in macular neovascularization (MNV) secondary to age-related macular degeneration after 2 years of aflibercept treatment under a treat-and-extend (T&E) regimen.Methods:This retrospective study analyzed the medical records for 26 eyes of 25 patients diagnosed with treatment-naive neovascular age-related macular degeneration and treated with aflibercept under a treat-and-extend regimen for 2 years. The areas of the MNV and vascular structures were assessed using swept-source optical coherence tomography angiography at baseline and after 2 years of treatment.Results:The mean MNV area increased significantly from 0.65 +/- 0.42 mm(2) at baseline to 0.78 +/- 0.45 mm(2) at 2 years. At 2 years, the mean change in the MNV area from baseline was 22% (interquartile range: 4%-60%). The baseline MNV area was negatively correlated with the change ratio of the MNV areas at 2 years and baseline (R = -0.68, P < 0.001). Nine of the 26 eyes (34.6%) showed newly formed mature vessels, and 7 eyes (26.9%) showed prominently developing preexisting mature vessels.Conclusion:Macular neovascularization expanded and showed vascular maturation under aflibercept treatment with a treat-and-extend regimen. The smaller the MNV at baseline, the greater is its expansion in 2 years.

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