Seven-year outcome after 1-year fixed regimen of intravitreal aflibercept injections followed by pro re nata treatment for neovascular age-related macular degeneration

Hama, Yuki; Miyata, Manabu; Ooto, Sotaro; Tamura, Hiroshi; Ueda-Arakawa, Naoko; Muraoka, Yuki; Miyake, Masahiro; Takahashi, Ayako; Wakazono, Tomotaka; Uji, Akihito; Yamashiro, Kenji; Tsujikawa, Akitaka

doi:10.1007/s00417-023-05982-w

Cited by 2 publications

(4 citation statements)

References 30 publications

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“…The 4-year BCVA significantly correlated with the baseline BCVA in multivariable analyses in both groups, which was consistent with findings of a 10-year observational study on myopic MNV with PM and a 7-year observational study on nAMD 3 , 12 . To maintain long-term BCVA after anti-VEGF therapy, early detection and subsequent early treatment are also important for non-PM and PM.…”

Section: Discussionsupporting

confidence: 88%

“…The treatment course in the eyes with non-PM or PM was different from that in the eyes with nAMD using a PRN regimen. For nAMD, the mean annual number of IVA or IVR was reported to be 2.5–3.0, and it did not decrease during the 7-year observation period 12 . Considering the required injection number, the MNV activity in the eyes with highly myopic non-PM would range between that of the eyes with PM and that of the eyes with nAMD.…”

Section: Discussionmentioning

confidence: 97%

“…However, no prior study on this topic has been conducted for more than 2 years. The mean ages of patients who first received anti-VEGF therapy for MNV in high myopia and neovascular age-related macular degeneration (nAMD) were 62.8 ± 8.9 and 73.2 ± 7.4 years, respectively 3 , 12 . Considering the longer life expectancy in patients with myopic MNV, longer-term observation studies are desired.…”

Section: Introductionmentioning

confidence: 99%

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Differences between pathologic and non-pathologic high myopia in 4-year outcomes of anti-VEGF therapy for macular neovascularization

Honda,

Miyata,

Miyake

et al. 2024

Sci Rep

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This retrospective observational study aimed to investigate the difference in 4-year outcomes of ranibizumab or aflibercept therapy for macular neovascularization (MNV) with high myopia between pathologic myopia (PM) and non-PM. This study was conducted at Kyoto University Hospital and included consecutive treatment-naïve eyes with active myopic MNV, in which a single intravitreal ranibizumab or aflibercept injection was administered, followed by a pro re nata (PRN) regimen for 4 years. Based on the META-PM study classification, eyes were assigned to the non-PM and PM groups. This study analyzed 118 eyes of 118 patients (non-PM group, 19 eyes; PM group, 99 eyes). Baseline, 1-year, and 2-year best-corrected visual acuity (BCVA) were significantly better in the non-PM group (P = 0.02, 0.01, and 0.02, respectively); however, the 3-year and 4-year BCVA were not. The 4-year BCVA course was similar in both groups. However, the total number of injections over 4 years was significantly higher in the non-PM than in the PM group (4.6 ± 2.6 vs. 2.9 ± 2.6, P = 0.001). Four-year BCVA significantly correlated only with baseline BCVA in both non-PM (P = 0.047, β = 0.46) and PM groups (P < 0.001, β = 0.59). In conclusion, over the 4-year observation period, the BCVA course after anti-VEGF therapy for myopic MNV was similar in the eyes with non-PM and those with PM; however, more additional injections in a PRN regimen were required in the eyes with non-PM compared to those with PM. Thus, more frequent and careful follow-up is required for the eyes with non-PM compared with those with PM to maintain long-term BCVA.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

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Differences between pathologic and non-pathologic high myopia in 4-year outcomes of anti-VEGF therapy for macular neovascularization

Honda,

Miyata,

Miyake

et al. 2024

Sci Rep

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“…This may be indicative of a progression in the course of PDR itself or potentially linked to our therapeutic regimen. Further prospective research is warranted to validate this observation [48][49][50] . Throughout the course of treatment, potential occurrences such as new VH, exacerbation of pre-existing cataracts, and post-cataract development may contribute to a decline in the patient's visual acuity.…”

Section: Discussionmentioning

confidence: 67%

Intravitreal conbercept injection with panretinal photocoagulation for high-risk proliferative diabetic retinopathy with vitreous hemorrhage

Xu,

Shen

2024

Int J Ophthalmol

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AIM: To assess the clinical efficacy and safety of combining panretinal photocoagulation (PRP) with intravitreal conbercept (IVC) injections for patients with high-risk proliferative diabetic retinopathy (HR-PDR) complicated by mild or moderate vitreous hemorrhage (VH), with or without diabetic macular edema (DME). METHODS: Patients diagnosed with VH with/without DME secondary to HR-PDR and received PRP combined with IVC injections were recruited in this retrospective study. Upon establishing the patient’s diagnosis, an initial IVC was performed, followed by prompt administration of PRP. In cases who significant bleeding persisted and impeded the laser operation, IVC was sustained before supplementing with PRP. Following the completion of PRP, patients were meticulously monitored for a minimum of six months. Laser therapy and IVC injections were judiciously adjusted based on fundus fluorescein angiography (FFA) results. Therapeutic effect and the incidence of adverse events were observed. RESULTS: Out of 42 patients (74 eyes), 29 were male and 13 were female, with a mean age of 59.17±12.74y (33-84y). The diabetic history was between 1wk and 26y, and the interval between the onset of visual symptoms and diagnosis of HR-PDR was 1wk-1y. The affected eye received 2.59±1.87 (1-10) IVC injections and underwent 5.5±1.02 (4-8) sessions of PRP. Of these, 68 eyes received PRP following 1 IVC injection, 5 eyes after 2 IVC injections, and 1 eye after 3 IVC injections. Complete absorption of VH was observed in all 74 eyes 5-50wk after initial treatment, with resolution of DME in 51 eyes 3-48wk after initial treatment. A newly developed epiretinal membrane was noted in one eye. Visual acuity significantly improved in 25 eyes. No complications such as glaucoma, retinal detachment, or endophthalmitis were reported. CONCLUSION: The study suggests that the combination of PRP with IVC injections is an effective and safe modality for treating diabetic VH in patients with HR-PDR.

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Seven-year outcome after 1-year fixed regimen of intravitreal aflibercept injections followed by pro re nata treatment for neovascular age-related macular degeneration

Cited by 2 publications

References 30 publications

Differences between pathologic and non-pathologic high myopia in 4-year outcomes of anti-VEGF therapy for macular neovascularization

Differences between pathologic and non-pathologic high myopia in 4-year outcomes of anti-VEGF therapy for macular neovascularization

Intravitreal conbercept injection with panretinal photocoagulation for high-risk proliferative diabetic retinopathy with vitreous hemorrhage

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