HAMBURG — A new “observe and plan” treatment regimen may allow for the creation of effective, customized follow-up and retreatment schedules, reducing the burden of age-related macular degeneration care, according to a speaker.
Several studies and a long experience with intravitreal anti-VEGF have shown the need for AMD retreatment is highly variable among patients, but relatively stable among individuals, Irmela Mantel, MD, said at the Euretina meeting.
The “observe and plan” regimen uses a loading dose of 3 monthly injections followed by an observation phase of monthly visits to find out what may be the individual interval between the third injection and the first-time recurrence.
“We then go on to a planned retreatment phase, in which we administer a series of fixed 2 to 3 injections at the same interval shortened by 2 weeks with no intermediate visits,” she said.
Control visits are then performed every 3 to 6 months in order to adjust the interval by a half-month, according to the individual outcomes, and plan a new series of 2 to 3 injections.
A prospective study including 115 eyes of 104 patients over a period of 2 years showed good and stable visual acuity outcomes and decreased central retinal thickness.
“The main number of visits after baseline was 4 in the first year and 3 in the second year. The mean number of injections was 7.8 in the first year and 5.8 in the second year. The mean treatment interval after the loading dose was 2.08 months over the two years,” Mantel said.
“This regimen allows significant visual improvement with a greatly reduced number of visits. This may increase the capacity of institutions to cope with the burden of AMD,” Mantel concluded.
Disclosures: Mantel is a consultant to Novartis, Bayer and Allergan.