"TREAT AND EXTEND" DOSING OF INTRAVITREAL ANTIVASCULAR ENDOTHELIAL GROWTH FACTOR THERAPY FOR TYPE 3 NEOVASCULARIZATION/RETINAL ANGIOMATOUS PROLIFERATION

Purpose: The purpose of this study was to analyze long-term outcomes for the treatment of type 3 neovascularization/retinal angiomatous proliferation using a "Treat and Extend" dosing regimen for antivascular endothelial growth factor therapy. Methods: This was a retrospective analysis of visual acuity and optical coherence tomography data of 11 eyes of 10 consecutive patients with newly diagnosed type 3 neovascularization/retinal angiomatous proliferation treated with intravitreal bevacizumab and/or ranibizumab with at least a 12-month follow-up. Three monthly injections were followed by continued treatment at intervals increasing by 2 weeks per visit, to a maximum of 10 weeks, unless clinical or optical coherence tomography evidence of persistent or recurrent fluid was present, in which case, the interval was shortened. Results: Mean baseline Snellen visual acuity was 20/80, improved to 20/40 at 1 month, and was maintained throughout the 36-month period (n = 11 at 12 months, n = 10 at 24 months, and n = 8 at 36 months) (P < 0.04, paired t-test). The mean center point optical coherence tomography thickness decreased from 320 mu m to 180-230 mu m, and was maintained during the study period (P < 0.02). The mean number of injections was seven in the first year, six in the second year, and seven in the third year. Conclusion: "Treat and Extend" antivascular endothelial growth factor dosing in type 3 neovascularization/retinal angiomatous proliferation delivers promising outcomes at a reduced burden for the patient and health care system compared with monthly and optical coherence tomography-guided dosing regimens. RETINA 29:1424-1431, 2009