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Treat-and-extend regimen for CRVO shows modest success
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PHILADELPHIA — A treat-and-extend regimen of anti-VEGF therapy for macular edema from central retinal vein occlusion offered advantages but was less successful than a similar protocol for age-related macular degeneration, according to a study presented here.
Advantages of a treat-and-extend regimen for CRVO included fewer office visits and injections, a lower risk of side effects and lower cost, Christopher J. Brady, MD, said at the Wills Eye Institute Annual Conference.
Christopher J. Brady
“Compared with macular degeneration, the treat-and-extend regimen appears to be less successful,” Brady said.
The retrospective study included 66 patients who underwent injections of Avastin (bevacizumab, Genentech) or Lucentis (ranibizumab, Genentech) for at least 6 months; 25 patients were treatment-naïve. Mean patient age was about 74 years.
Results showed that mean duration of symptoms was 131 days. Seven patients underwent a treat-and-extend regimen. Each patient received about five injections.
Office visits were successfully extended for two patients.
“We’re not quite sure why. This may have to do with pathophysiologic differences between the two disease states. It may have to do with demographic factors. A younger population base may be less likely to adhere to a strict regimen,” Brady said.
Mean improvement in visual acuity was two lines, compared with three lines in the CRUISE trial. Central macular thickness improved 229.4 µm, compared with 452 µm in the CRUISE trial.
A reduction of one injection, multiplied by the number of patients treated over a year, saved about $60,000, Brady said.
Limitations of the study included the retrospective design and non-standardized visual acuity metrics, he said.
Disclosure: Brady has no relevant financial disclosures.