J Korean Ophthalmol Soc.  2020 Jun;61(6):630-638. 10.3341/jkos.2020.61.6.630.

Clinical Outcomes after Switching from As-needed to Proactive Injections in the Neovascular Age-related Macular Degeneration

• Lim SH
• Hwang JH
• Kim JW
• Kim CG
• Lee DW
• Kim JH

• KMID: 2502968
• DOI: http://doi.org/10.3341/jkos.2020.61.6.630

Abstract

Purpose
To evaluate long-term clinical outcomes in patients with neovascular age-related macular degeneration (AMD) who were treated with an as-needed regimen but were switched to a proactive regimen during the course of treatment.
Methods
This retrospective study included 23 eyes with neovascular AMD which were initially treated with an as-needed regimen, but switched to a proactive regimen during the course of treatment. The duration of the as-needed phase was compared to that of the proactive phase. In addition, the number of injections per year and the degree of visual deterioration per year were compared between the two phases.
Results
The duration of the as-needed and proactive phases were 17.9 ± 8.3 months and 31.3 ± 13.2 months, respectively. The duration of the proactive phase was significantly longer (p < 0.001). The number of injections per year during the proactive phase (4.4 ± 1.0) was significantly more than that during the as-needed phase (2.8 ± 1.0) (p < 0.001). The degree of visual deterioration per year during the as-needed phase (0.08 ± 0.14) was slightly greater than that during the proactive phase (0.04 ± 0.08). However, the difference was not statistically significant (p = 0.229).
Conclusions
The number of injections was higher after switching to the proactive regimen. However, the degree of visual deterioration was slightly lower than that noted during the as-needed phase. Further studies with a more controlled design are needed to determine more clearly the impact of switching treatment regimens on long-term clinical outcomes.

Keyword

Age-related macular degeneration; Anti-vascular endothelial growth factor; As-needed; Choroidal neovascularization; Proactive