Two-Year Outcomes of Treat‐and‐Extend Intravitreal Aflibercept for Exudative Age-related Macular Degeneration: A Prospective Study

Abstract Purpose To report the 2-year outcomes of intravitreal aflibercept injections (IAIs) in Japanese patients with neovascular age-related macular degeneration (AMD) using a 1-month adjusted treat-and-extend (TAE) regimen. Design This was a multicenter, prospective, non-randomized, interventional study. Participants Ninety-seven eyes of 97 patients with treatment-nai¨ve AMD were studied at 3 tertiary ophthalmological institutions. Methods The patients were treated with three consecutive monthly IAIs followed by the TAE regimen with a 1-month adjustment for a maximum of 3 months. Our TAE regimen allowed us to shorten and extend the treatment intervals even after a 3- and/or 1-month treatment interval was reached. The best-corrected visual acuity (BCVA), the central retinal thickness (CRT), and the subfoveal choroidal thickness (SCT) were analyzed. Main Outcome Measures The mean changes in the BCVA, CRT, and SCT from the baseline to 2 years after initiating the treatment were determined. In addition, the number of injections was also determined. Results The mean BCVA significantly improved from 0.27 logarithm of the minimum angular of resolution (logMAR) units to 0.14 logMAR units at 2 years (P Conclusions Intravitreal aflibercept injections with a 1-month adjusted TAE regimen significantly improved the BCVA and CRT with a reduced number of injections at 2 years. The treatment interval was adjusted to extend to 3 months in 60% and shorten to 1 month in 20% of the eyes at 2 years.