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Treat-and-Extend Regimens for the Management of Neovascular Age-related Macular Degeneration and Polypoidal Choroidal Vasculopathy: Consensus and Recommendations From the Asia-Pacific Vitreo-retina Society.

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机构： [1]Retina Division, Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand. [2]Department of Ophthalmology, Yeungnam University College of Medicine, Daegu, South Korea. [3]Hong Kong Eye Hospital, Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Hong Kong. 42010 Retina & Macula Centre, Kowloon, Hong Kong. [4]Singapore Eye Research Institute, Singapore National Eye Centre, Duke-NUS Medical School, National University of Singapore, Singapore. [5]Ministry of Health, Hospital Shah Alam, Selangor, Malaysia. [6]Department of Ophthalmology, Shiga University of Medical Science, Otsu, Shiga, Japan. [7]University of Sydney (Westmead Institute for Medical Research), Sydney, NSW, Australia. [8]Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan [9]College of Medicine, National Taiwan University, Taipei, Taiwan. [10]Department of Ophthalmology, College of Medicine, Rangsit University, Rajavithi Hospital, Bangkok, Thailand. [11]Department of Ophthalmology, The University of Hong Kong, Hong Kong, China. [12]Department of Ophthalmology, Kagoshima University, Kagoshima, Japan. [13]Retina-Vitreous Service, Aravind Eye Care System, Chennai, India. [14]Department of Ophthalmology, Peking Union Medical College Hospital, Beijing, China. [15]C-MER Dennis Lam & Partners Eye Center, C-MER International Eye Care Group, Hong Kong, China [16]C-MER International Eye Research Center of The Chinese University of Hong Kong (Shenzhen), Shenzhen, China. [17]Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan [18]College of Medicine, Chang Gung University, Taoyuan, Taiwan. [19]Sydney Retina Clinic, Sydney Eye Hospital, University of Sydney, Sydney, NSW, Australia. [20]Eye & Retina Surgeons, Camden Medical Centre, Singapore.

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Review and provide consensus recommendations on use of treat-and-extend (T&E) regimens for neovascular age-related macular degeneration (nAMD) and polypoidal choroidal vasculopathy (PCV) management with relevance for clinicians in the Asia-Pacific region.A systematic search of MEDLINE, EMBASE, and Cochrane databases, and abstract databases of the Asia-Pacific Vitreo-retina Society, European Society of Retina Specialists, American Academy of Ophthalmology, and Controversies in Ophthalmology: Asia-Australia congresses, was conducted to assess evidence for T&E regimens in nAMD. Only studies with ≥100 study eyes were included. An expert panel reviewed the results and key factors potentially influencing the use of T&E regimens in nAMD and PCV, and subsequently formed consensus recommendations for their application in the Asia-Pacific region.Twenty-seven studies were included. Studies demonstrated that T&E regimens with aflibercept, ranibizumab, or bevacizumab in nAMD, and with aflibercept in PCV, were efficacious and safe. The recommendation for T&E is, after ≥3 consecutive monthly loading doses, treatment intervals can be extended by 2 to 4 weeks up to 12 to 16 weeks. When disease activity recurs, the recommendation is to reinject and shorten intervals by 2 to 4 weeks until fluid resolution, after which treatment intervals can again be extended. Intraretinal fluid should be treated until resolved; however, persistent minimal subretinal fluid after consecutive treatments may be tolerated with treatment intervals maintained or extended if the clinical condition is stable.T&E regimens are efficacious and safe for nAMD and PCV, can reduce the number of visits, and minimize the overall burden for clinicians and patients.Copyright © 2021 by Asia Pacific Academy of Ophthalmology.

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大类 | 3 区医学

小类 | 2 区眼科学

第一作者：

第一作者机构： [1]Retina Division, Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand. [*1]Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, 110 Inthawaroros Road, Tambon Sriphoom, Amphur Muang, Chiang Mai 50200, Thailand.

通讯作者：

通讯机构： [1]Retina Division, Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand. [*1]Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, 110 Inthawaroros Road, Tambon Sriphoom, Amphur Muang, Chiang Mai 50200, Thailand.

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