RATES OF EXUDATIVE RECURRENCE FOR EYES WITH INACTIVATED WET AGE-RELATED MACULAR DEGENERATION ON 12-WEEK INTERVAL DOSING WITH BEVACIZUMAB THERAPY

Retina. 2020 Apr;40(4):679-685. doi: 10.1097/IAE.0000000000002446.

Abstract

Purpose: To determine the recurrence rate of exudative age-related macular degeneration (wet AMD) in patients on 12-week dosing interval anti-vascular endothelial growth factor (anti-VEGF) bevacizumab therapy.

Methods: A retrospective chart review was performed on wet AMD patients treated with anti-VEGF therapy using a "treat-and-extend" methodology at one physician's practice site over 2 years (2012-2014). Charts were evaluated for visual acuity, anti-VEGF agent used, treatment interval, duration of treatment, trials off of anti-VEGF therapy, evidence of exudation, and wet AMD recurrence characteristics.

Results: Three hundred and twenty-one wet AMD patients were treated. Fifty-seven eyes were without active exudation by clinical examination or optical coherence tomography (OCT) and were maintained on repeating 12-week interval suppressive anti-VEGF therapy. Sixteen percent (8/49) showed exudation recurrence with an average 10% cumulative recurrence rate per year for eyes on bevacizumab. Eight eyes without active exudation were discontinued off of bevacizumab therapy. Sixty-three percent (5/8) demonstrated recurrence on average 4 months after stopping therapy.

Conclusion: The findings in this study suggest that if a patient can be extended to 12-week interval bevacizumab therapy, there is on average a 10% chance of recurrence with each successive year. If anti-VEGF therapy is discontinued in these patients, there is an increased chance of recurrence by 4 months.

MeSH terms

  • Aged, 80 and over
  • Angiogenesis Inhibitors / administration & dosage
  • Bevacizumab / administration & dosage*
  • Colorado / epidemiology
  • Dose-Response Relationship, Drug
  • Female
  • Fluorescein Angiography / methods
  • Follow-Up Studies
  • Fundus Oculi
  • Humans
  • Incidence
  • Intravitreal Injections
  • Male
  • Receptors, Vascular Endothelial Growth Factor / antagonists & inhibitors
  • Recurrence
  • Retrospective Studies
  • Time Factors
  • Tomography, Optical Coherence / methods
  • Visual Acuity*
  • Wet Macular Degeneration / diagnosis
  • Wet Macular Degeneration / drug therapy
  • Wet Macular Degeneration / epidemiology*

Substances

  • Angiogenesis Inhibitors
  • Bevacizumab
  • Receptors, Vascular Endothelial Growth Factor