An extensive analysis of data garnered from the Fight Retinal Blindness (FRB) Project indicated that the treat-and-extend regimens used to manage patients with neovascular age-related macular degeneration (AMD) are reliable alternative approaches that achieve good outcomes compared with monthly and as-needed regimens.
In this large database observational study, in which patients were in the maintenance phase of treatment with anti-vascular endothelial growth factor (anti-VEGF) drugs, the mean visual acuity level was maintained and the median interval of injections gradually increased to about 2 months after the first year of the treat-and-extend regimens. Reactivation of the AMD lesions occurred most often at about 8 weeks.
Mark C. Gillies, MBBS, PhD, who presented the study data on behalf of the Fight Retinal Blindness project, explained that the treat-and-extend regimen was defined as administration of monthly treatment until the lesions became inactive; stepwise extension of the treatment interval when the lesion was inactive; and reduction of the treatment interval when the lesion became active. The rationale for treat-and-extend regimens was based on previous observational studies that reported good outcomes with fewer injections of anti-VEGF drugs.
Dr. Gillies is professor, Department of Clinical Ophthalmology, The University of Sydney, and director, Macula Research Group, The Save Sight Institute, Sydney Medical School, University of Sydney, Australia.