Twenty-four-month outcomes of inflammatory choroidal neovascularisation treated with intravitreal anti-vascular endothelial growth factors: a comparison between two treatment regimens.
Adult
Angiogenesis Inhibitors
/ therapeutic use
Bevacizumab
/ administration & dosage
Choroidal Neovascularization
/ drug therapy
Coloring Agents
/ administration & dosage
Female
Fluorescein Angiography
Glucocorticoids
/ therapeutic use
Humans
Indocyanine Green
/ administration & dosage
Intravitreal Injections
Male
Middle Aged
Retrospective Studies
Time Factors
Tomography, Optical Coherence
Treatment Outcome
Uveitis
/ drug therapy
Vascular Endothelial Growth Factor A
/ antagonists & inhibitors
Visual Acuity
/ physiology
CNV
aflibercept
anti-VEGF
bevacizumab
drugs
inflammation
inflammatory choroidal neovascularization
neovascularisation
ranibizumab
regimen
retina
treatment
uveitis
Journal
The British journal of ophthalmology
ISSN: 1468-2079
Titre abrégé: Br J Ophthalmol
Pays: England
ID NLM: 0421041
Informations de publication
Date de publication:
08 2020
08 2020
Historique:
received:
18
09
2019
revised:
17
10
2019
accepted:
05
11
2019
pubmed:
21
11
2019
medline:
16
1
2021
entrez:
21
11
2019
Statut:
ppublish
Résumé
There is still no established treatment regimen for eyes with inflammatory choroidal neovascularisation (iCNV) treated with intravitreal anti-vascular endothelial growth factor (VEGF) injections. This study compared the 24-month outcomes of two treatment regimens of anti-VEGF injections in eyes with iCNV. Eyes with iCNV treated with anti-VEGF injections were divided into two groups: eyes treated with a loading phase of 3 monthly injections and then re-treated as needed (LOADING group) and eyes treated as needed from the beginning (PRN group). Visual acuity (VA), number of injections and iCNV recurrences at 24 months were compared between the groups. Eighty-two eyes were included, 42 in the LOADING and 40 in the PRN group. Baseline VA (mean(SD)) was 57.3 (15.8) letters in the LOADING vs 60.7 (15.6) letters in the PRN group (p=0.32). The VA (mean (95% CI)) increased at 3 months (+14.8 (10.6 to 18.9) and +11.2 (6.4 to 16) letters in the LOADING and PRN group, respectively) and remained significantly higher than baseline over the entire follow-up in both groups (all p<0.001). At 24 months, there was no difference in VA between the LOADING and PRN group (72.3 (14.0) vs 74.7 (11.3) letters, p=0.36) but the LOADING group received significantly more injections (median (Q1-Q3)) than the PRN (4.5 (3-7) vs 2.5 (2-3.2), p<0.0001). The iCNV recurrences were similar in both groups. iCNV responded well to anti-VEGF with significant and sustained VA improvement. The loading phase did not confer any advantage in terms of outcomes. PRN regimen from the beginning was as effective as more intensive treatment.
Sections du résumé
BACKGROUND AND AIM
There is still no established treatment regimen for eyes with inflammatory choroidal neovascularisation (iCNV) treated with intravitreal anti-vascular endothelial growth factor (VEGF) injections. This study compared the 24-month outcomes of two treatment regimens of anti-VEGF injections in eyes with iCNV.
METHODS
Eyes with iCNV treated with anti-VEGF injections were divided into two groups: eyes treated with a loading phase of 3 monthly injections and then re-treated as needed (LOADING group) and eyes treated as needed from the beginning (PRN group). Visual acuity (VA), number of injections and iCNV recurrences at 24 months were compared between the groups.
RESULTS
Eighty-two eyes were included, 42 in the LOADING and 40 in the PRN group. Baseline VA (mean(SD)) was 57.3 (15.8) letters in the LOADING vs 60.7 (15.6) letters in the PRN group (p=0.32). The VA (mean (95% CI)) increased at 3 months (+14.8 (10.6 to 18.9) and +11.2 (6.4 to 16) letters in the LOADING and PRN group, respectively) and remained significantly higher than baseline over the entire follow-up in both groups (all p<0.001). At 24 months, there was no difference in VA between the LOADING and PRN group (72.3 (14.0) vs 74.7 (11.3) letters, p=0.36) but the LOADING group received significantly more injections (median (Q1-Q3)) than the PRN (4.5 (3-7) vs 2.5 (2-3.2), p<0.0001). The iCNV recurrences were similar in both groups.
CONCLUSIONS
iCNV responded well to anti-VEGF with significant and sustained VA improvement. The loading phase did not confer any advantage in terms of outcomes. PRN regimen from the beginning was as effective as more intensive treatment.
Identifiants
pubmed: 31744798
pii: bjophthalmol-2019-315257
doi: 10.1136/bjophthalmol-2019-315257
doi:
Substances chimiques
Angiogenesis Inhibitors
0
Coloring Agents
0
Glucocorticoids
0
VEGFA protein, human
0
Vascular Endothelial Growth Factor A
0
Bevacizumab
2S9ZZM9Q9V
Indocyanine Green
IX6J1063HV
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1052-1056Informations de copyright
© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: AI: Allergan (financial support), Novartis (consultant), Bayer (consultant). FP: Zeiss (consultant), Bayer (speaker), Novartis (speaker), Allergan (consultant), AbbVie (consultant). LC: Abbvie Code C (consultant), Santen Code C (consultant). MCG: Novartis (consultant), Bayer (recipient), Ophtea (consultant), Novartis (recipient), Allergan (consultant), Allergan (recipient), Bayer (consultant), Ophtea (recipient). PJM: AbbVie (financial support), AbbVie (consultant), AbbVie (recipient), Allergan (financial support), Allergan (consultant), Allergan (recipient), Shire (consultant), Shire (recipient), Zeiss (financial support).