Fixed Regimen Treatment in Unselected Naive Patients Cohort with Neovascular Age-Related Macular Degeneration

The current treatment of neovascular age-related macular degeneration (nAMD) generates an excessive care pressure in the public health system. The search for a satisfactory treatment regimen, whose anatomical and functional stability may be achieved, is a challenge and a goal to be reached. We analyzed the outcomes in a patient cohort under fixed regimen treatment with intravitreal aflibercept (IVA). A retrospective study, with at least 1-year follow-up, in consecutive treated unselected naive patients was carried out. Standard protocol was performed and evaluated at baseline, month 4 (after loading dose, LD), and month 12 (after fixed bimonthly regimen). One hundred six patients (123 eyes) aged 80.3 +/- 7.7 years were included, receiving 6.8 +/- 0.7 IVA. Visual acuity gain after LD was 5.5 +/- 12.0 letters (p<0.0001). At month 12, 23 eyes (18.7%) gained >= 15 letters and 58 (47.1%) had best-corrected visual acuity >= 20/40 (70 letters). The improvement in visual acuity was lower in patients with polypoidal choroidal vasculopathy (+4.9 +/- 18.1 letters; p = 0.2544) and somewhat higher in patients with retinal angiomatous proliferation (+5.4 +/- 12.3 letters; p=0.0373). Dry macula was present in only 9.8% of cohort at baseline vs. 69.7% at month 12 (p<0.0001). Atrophy was the most observed complication and related to the elderly patients. The average of follow-up visits was 3 +/- 0.5. Functional and anatomical improvement were observed with IVA in a fixed bimonthly regimen treatment after LD, with results maintained up to one year with a good compliance. The fixed bimonthly regimen optimized patient management and logistic issues.