Incidence and characteristics of neovascular age-related macular degeneration with over a 12-month remission after three monthly aflibercept administration: 60 months results of a pro re nata regimen.

Abstract

Abstract Purpose: To investigate the characteristics of patients with over a 12-month remission after three monthly intravitreal aflibercept injections (IVA) followed by a pro re nata regimen for exudative age-related macular degeneration (AMD). Methods: One-hundred and forty-four eyes with exudative AMD were included. All patients received three monthly IVA as a loading dose, followed by an as-needed regimen for 60 months. Patients were classified into the remission and recurrence groups depending on the presence or absence of a 12-month remission. ARMS2 A69S and CFH I62V were genotyped in all cases. Results: During the study, 82 eyes (56.9%) showed 12 months or more remission at least once. The cumulative incidence rate of a 12-month remission showed a plateau pattern and converged to 60% (y=-166.26x-2.172+0.6, R2=0.8168). Patients in the remission group were younger than those in the recurrence group (p<0.001) and had less risk allele frequency of the ARMS2 gene than the recurrence group (p<0.001). The longer the remission interval was prolonged, the better visual acuity was achieved at the 60-month visit (p<0.001). Conclusion: Fifty-seven percent of patients showed a 12-month remission or more at least once during a 60-month follow-up, suggesting that patients with no reactivation can prolong the treatment interval.