Age-related macular degeneration (AMD) is a leading cause of blindness in people over 50 years old. Neovascular AMD, the most severe form and the most severe is characterized by the appearance, spread and growth of subretinal neovessels. One of the major molecular mediators is the endothelial growth factor vascular (VEGF). Intra-vitreous (IVI) injection of an anti-VEGF may slow the progression of Neovascular AMD and stabilize vision in the majority of cases. Ranibizumab (Lucentis®) is one of the anti-VEGF molecules approved in Belgium to treat neovascular AMD. At the start of its use, ranibizumab was first injected monthly and then according to the "reactive" protocol. Over time, a new strategy of treatment was born: the "treat-and-extend" (T\&E). This is 'made to measure' protocol for each patient aiming to reduce the frequency of injections while guaranteeing inactivity of the disease. It starts with the loading dose, i.e. 3 injections given 4 weeks apart. Subsequently, the interval is lengthened by slices of 1 or 2 weeks provided that the visual and anatomical results remain stable. In the event of deterioration, the interval is shortened while keeping a minimum of 4 weeks between each IIV. The efficacy and safety of ranibizumab, when used in a proactive regimen of T\&E, has been shown in the CANTREAT randomized controlled trial. However, there is a lack of more data on T\&E used in current practice, and particularly on the number of injections and treatment intervals over a minimum treatment period of 24 months. The aim of this retrospective study carried out at the CHU Brugmann Hospital is to determine the number of injections and the intervals necessary to have encouraging results in visual acuity over a treatment period of at least two years.
Study Type
OBSERVATIONAL
Enrollment
34
Data extraction from medical files
CHU Brugmann
Brussels, Belgium
Injections number (first 24 months of treatment)
Number of injections during the first 24 months of treatment
Time frame: first 24 months of treatment
Injections interval
Last injection interval during the 2nd year of treatment, in weeks
Time frame: during the 2nd year of treatment
Injection number (up to 4 years of treatment)
Number of injections during the 1st, 2nd, 3rd and 4th year of treatment
Time frame: up to 4 years of treatment
Injections interval (up to 4 years of treatment)
Last injection interval during the 1st, 2nd, 3rd and 4th year of treatment (if applicable), in weeks
Time frame: up to 4 years of treatment
Most stable injection interval
Most stable injection interval during the 2nd, 3rd and 4th year of treatment (if applicable), in weeks
Time frame: up to 4 years of treatment
Overall extension interval
Expected overall extension interval: by 1 week, 2 weeks, 3 weeks or 4 weeks
Time frame: up to 4 years of treatment
Covid 19 impact
Impact of Covid-19 on the injection interval
Time frame: up to 4 years of treatment
Number of follow-up visits
Number of follow-up visits during each year of treatment
Time frame: up to 4 years of treatment
Visual acuity
Visual acuity at baseline, after 90 days and at the end of each year of treatment in the study
Time frame: up to 4 years of treatment
Age
Age of the patient at baseline
Time frame: Baseline
Eye lesion type
Eye lesion type
Time frame: Baseline
Fluid
Presence or absence of intra-retinal fluid, subretinal fluid, detachment of the pigment epithelium
Time frame: Baseline
Fluid
Presence or absence of intra-retinal fluid, subretinal fluid, detachment of the pigment epithelium
Time frame: 90 days after baseline
Fluid
Presence or absence of intra-retinal fluid, subretinal fluid, detachment of the pigment epithelium
Time frame: once a year up to 4 years of treatment
Date of first symptoms
Date of first symptoms of neovascular AMD
Time frame: Baseline
Date of first injection
Date of first ranibizumab injection
Time frame: Baseline
Retinal thickness
Retinal thickness at baseline, after 90 days and at the end of each year of treatment
Time frame: up to 4 years of treatment
Treatment regimen
Has there been a change in treatment regimen after the first 12 months of treatment?
Time frame: first 12 months of treatment]
Number of patients stopping treatment (12-24 months)
Number of patients stopping treatment between 12 and 24 months of treatment
Time frame: between 12 and 24 months of treatment
Reason for stopping treatment (12-24 months)
Reason for stopping treatment between 12 and 24 months of treatment
Time frame: between 12 and 24 months of treatment
Number of patients stopping treatment (24-36 months)
Number of patients stopping treatment between 24 and 36 months of treatment
Time frame: between 24 and 36 months of treatment
Reason for stopping treatment (24-36 months)
Reason for stopping treatment between 24 and 36 months of treatment
Time frame: between 24 and 36 months of treatment
Number of patients stopping treatment (36-48 months)
Number of patients stopping treatment between 36 and 48 months of treatment
Time frame: between 36 and 48 months of treatment
Reason for stopping treatment (36-48 months)
Reason for stopping treatment between 36 and 48 months of treatment
Time frame: between 36 and 48 months of treatment
Number of patients stopping treatment (first 12 months)
Number of patients who stopped treatment in the first 12 months
Time frame: First 12 months of treatment
Reason for stopping treatment (first 12 months)
Reason for stopping treatment in the first 12 months
Time frame: First 12 months of treatment
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