Citation:Erden B, Bölükbaşı S, Özkaya A, Karabaş L, Alagöz C, Alkın Z, Artunay Ö, Bayramoğlu SE, Demir G, Demir M, Demircan A, Erdoğan G, Erdoğan M, Eriş E, Kaldırım H, Onur İU, Osmanbaşoğlu ÖA, Özdoğan Erkul S, Öztürk M, Perente İ, Sarıcı K, Sayın N, Yaşa D, Yılmaz İ, Yılmazabdurrahmanoğlu Z; Bosphorus Retina Study Group. Comparison of two different treatment regimens’ efficacy in neovascular age-related macular degeneration in Turkish population—based on real life data-Bosphorus RWE Study Group. Int J Ophthalmol 2020;13(1):104-111,doi:10.18240/ijo.2020.01.15
Comparison of two different treatment regimens’ efficacy in neovascular age-related macular degeneration in Turkish population—based on real life data-Bosphorus RWE Study Group
Received:May 18, 2019  Revised:September 27, 2019
Email this Article  Add to Favorites  Print
DOI:10.18240/ijo.2020.01.15
Key Words:aflibercept  neovascular age-related macular degeneration  ranibizumab  loading dose  treatment regimen
Fund Project:
                                                                          
AuthorInstitution
Burak Erden Ophthalmology Clinic, Okmeydanı Training and Research Hospital, Istanbul 34384, Turkey
Selim Bölükbaşı Ophthalmology Clinic, Okmeydanı Training and Research Hospital, Istanbul 34384, Turkey
Abdullah Özkaya Ophthalmology Clinic, Memorial Şişli Hospital, Istanbul 34384, Turkey
Levent Karabaş Department of Ophthalmology, Kocaeli University Faculty of Medicine, Kocaeli 41380, Turkey
Cengiz Alagöz Ophthalmology Clinic, Beyoğlu Eye Training and Research Hospital, Istanbul 34421, Turkey
Zeynep Alkın Ophthalmology Clinic, Beyoğlu Eye Training and Research Hospital, Istanbul 34421, Turkey
Özgür Artunay Ophthalmology Clinic, Beyoğlu Eye Training and Research Hospital, Istanbul 34421, Turkey
Sadık Etka Bayramoğlu Ophthalmology Clinic, Kanuni Sultan Süleyman Training and Research Hospital, Istanbul 34303, Turkey
Gökhan Demir Ophthalmology Clinic, Beyoğlu Eye Training and Research Hospital, Istanbul 34421, Turkey
Mehmet Demir Ophthalmology Clinic, Şişli Etfal Training and Research Hospital, Istanbul 34360, Turkey
Ali Demircan Ophthalmology Clinic, Beyoğlu Eye Training and Research Hospital, Istanbul 34421, Turkey
Gürkan Erdoğan Ophthalmology Clinic, Beyoğlu Eye Training and Research Hospital, Istanbul 34421, Turkey
Mehmet Erdoğan Ophthalmology Clinic, Şişli Etfal Training and Research Hospital, Istanbul 34360, Turkey
Erdem Eriş Ophthalmology Clinic, Beyoğlu Eye Training and Research Hospital, Istanbul 34421, Turkey
Havva Kaldırım Ophthalmology Clinic, Bağcılar Training and Research Hospital, Istanbul 34200, Turkey
İsmail Umut Onur Ophthalmology Clinic, Bakırköy Dr. Sadi Konuk Training and Research Hospital, Istanbul 34147, Turkey
Özen Ayrancı Osmanbaşoğlu Ophthalmology Clinic, Istanbul Training and Research Hospital, Istanbul 34098, Turkey
Sezin Özdoğan Erkul Ophthalmology Clinic, Istanbul Training and Research Hospital, Istanbul 34098, Turkey
Mine Öztürk Ophthalmology Clinic, Haseki Training and Research Hospital, Istanbul 34096, Turkey
İrfan Perente Ophthalmology Clinic, Beyoğlu Eye Training and Research Hospital, Istanbul 34421, Turkey
Kübra Sarıcı Ophthalmology Clinic, Kanuni Sultan Süleyman Training and Research Hospital, Istanbul 34303, Turkey
Nihat Sayın Ophthalmology Clinic, Kanuni Sultan Süleyman Training and Research Hospital, Istanbul 34303, Turkey
Dilek Yaşa Ophthalmology Clinic, Beyoğlu Eye Training and Research Hospital, Istanbul 34421, Turkey
İhsan Yılmaz Ophthalmology Clinic, Beyoğlu Eye Training and Research Hospital, Istanbul 34421, Turkey
Zeynep Yılmazabdurrahmanoğlu Ophthalmology Clinic, Bağcılar Training and Research Hospital, Istanbul 34200, Turkey
Hits: 425
Download times: 75
Abstract:
      AIM: To compare two different anti-vascular endothelial growth factor (anti-VEGF) treatment regimens’-a priori pro re nata (PRN) and PRN regimen following the loading phase-anatomical and functional results in neovascular age-related macular degeneration (nAMD) patients.

    METHODS: Totally 544 nAMD patients followed and treated with aflibercept (n=135) and ranibizumab (n=409) at 9 different centers between 2013 and 2015 were enrolled into this retrospective multicenter study. Patients with initial best corrected visual acuity (BCVA) interval of 1.3-0.3 (logMAR) and a minimum follow-up of 12mo were included. Patients under two different regimens-a priori pro re nata (1+PRN) or 3 consecutive intravitreal injections followed by a PRN regimen (3+PRN)-were compared in BCVA at 3th, 6th and 12th months, and in central macular thickness (CMT) at 6th and 12th months. The total study group, intravitreal ranibizumab (IVR) and intravitreal aflibercept (IVA) groups were evaluated separately.

    RESULTS: The mean CMT decreased in the 1+PRN (n=101) regimen from 407 to 358 and 340 μm and in the 3+PRN (n=443) group from 398 to 318 and finally to 310 μm at months 6 and 12, respectively. Anatomically, the CMT reduction at 6th month (48.5 vs 76.4; P<0.05) was statistically significant in favor of 3+PRN group. BCVA changed in 1+PRN group from 0.77 to 0.78, 0.75 and 0.75; in 3+PRN group from 0.81 to 0.69, 0.72, and 0.76 at months 3, 6, and 12, respectively. Visual gain was statistically better in 3+PRN group at 3th month (-0.01 vs 0.12; P<0.001). In IVR group, CMT reduction was in greater in 3+PRN at 6th (44 vs 72) and 12th month (61 vs 84), but statistically insignificant. The 3+PRN group revealed statistically better visual results at 3th month (-0.02 vs 0.11, P<0.05). In IVA group, although statistically insignificant, CMT reduction (61 vs 89, 6th month; 85 vs 97, 12th month) and visual gain (0.02 vs 0.16; 0.02 vs 0.14; 0.05 vs 0.11) was found in favor of 3+PRN group at all visits.

    CONCLUSION: The loading dose of anti-VEGF treatments in nAMD leads to significantly better anatomical and functional results, regardless of the agent, specially in early follow-up interval.

PMC FullText Html:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6942941/
Supplementary Material
PDF Fulltext  Download reader  HTML Fulltext   View/Add Comment