Purpose:

To evaluate 2-year visual acuity outcome of a treat-and-extend protocol of anti–vascular endothelial growth factor treatment in age-related macular degeneration.

Methods:

In this prospective cohort study, 120 age-related macular degeneration patients with choroidal neovascularization received 3 initial monthly ranibizumab or bevacizumab injections; monthly injections were continued until there was no choroidal neovascularization activity (subretinal/intraretinal fluid, loss of> 5 letters, or persistent/recurrent retinal hemorrhage). When there was no choroidal neovascularization activity, the interval to the next visit/injection was extended by 2 weeks to a maximum of 12 weeks. In the presence of choroidal neovascularization activity, this interval was shortened by 2 weeks. Main outcome measures included the percentage losing< 15 letters and the mean visual acuity change after 12 months and 24 months.

Results:

Mean baseline visual acuity was 51.2±12.1 Early Treatment Diabetic Retinopathy Study scores. Mean visual acuity change from baseline was+ 9.5±10.9 and+ 8.0±12.9 letters after 12 months and 24 months, respectively, with, on average, 8.6±1.1 visits/injections in the first year and 5.6±2.0 in the second year. After 12 months and 24 months, 97.5% and 95.0% of patients, respectively, lost< 15 letters.

Conclusion:

The “inject-and-extend” protocol—with fewer injections and visits—delivered outcomes comparable to those of the pivotal clinical trials of monthly ranibizumab.