Treat-and-extend treatment protocol may not relieve subretinal fluid, but patients maintain vision

NEW YORK — A treat-and-extend therapy regimen may not completely resolve subretinal fluid in patients with newly diagnosed type 1 neovascularization, although patients in a retrospective study treated under the protocol maintained vision.

In the study, 18 eyes of 16 patients were treated with three loading doses of Lucentis (ranibizumab, Genentech) or Avastin (bevacizumab, Genentech) followed by injections at intervals increasing by 2 weeks per dose unless optical coherence topography showed persistent or recurrence of fluid on the retina.

Over the course of 24 months, patients required a mean 12 doses. According to K. Bailey Freund, MD, at Retina Congress 2009, 15 of 18 eyes continued to manifest subretinal fluid visible on OCT throughout the study; only one patient developed geographic atrophy. Visual acuity remained stable; median visual acuity was 0.54 logMAR at baseline, 0.49 logMAR at 24 months and 0.52 logMAR at 36 months.

"I was surprised to see that many eyes did well despite the presence of fluid throughout the study," Dr. Freund said.

Patients with continued fluid, particularly subretinal fluid, were not extended beyond 1-month intervals, Dr. Freund said.