STRICT PRO RE NATA VERSUS TREAT-AND-EXTEND REGIMENS IN NEOVASCULAR AGE-RELATED MACULAR DEGENERATION

黄斑变性 自然科学 医学 眼科 内科学 血管抑制剂 贝伐单抗 化疗
作者
Hwa-Shin Fang,Chyi‐Huey Bai,Cheng‐Kuo Cheng
出处
期刊:Retina-the Journal of Retinal and Vitreous Diseases [Lippincott Williams & Wilkins]
卷期号:43 (3): 420-432 被引量:8
标识
DOI:10.1097/iae.0000000000003690
摘要

Purpose: To compare the visual and anatomical outcomes between strict pro re nata (strict PRN) and treat-and-extend (T&E) anti–vascular endothelial growth factor (anti-VEGF) regimens for neovascular age-related macular degeneration (nAMD). Methods: A meta-analysis of 1-year and 2-year changes between strict PRN and T&E anti-VEGF regimens were conducted in both randomized controlled trials (RCTs) and real-world studies (RWSs). The best-corrected visual acuity (BCVA), central retinal thickness (CRT), and weighted mean numbers of visits and injections were evaluated. Results: A total of 19 RCTs and 23 RWSs (2,530 eyes in strict PRN and 4,399 eyes in T&E) were included. Mean BCVA change in strict PRN group in both 1-year and 2-year (5.95 and 5.78, respectively) was noninferior to the T&E group (7.85 and 5.96, respectively). Mean CRT changes were also similar in both strict PRN and T&E groups. Mean number of visits were significantly more in the strict PRN group, whereas mean number of injections was significantly more in the T&E group. Conclusion: The strict PRN regimen demonstrates a noninferior BCVA improvement to the T&E regimen, achieving fewer injections, and may be both economically and medically beneficial. Both selections should be provided to patients with an overall consideration.
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