A total of 50 treatment naive patients with neovascular AMD received aflibercept for two consecutive years; in Year 1 a fixed bimonthly regime was used followed by either a capped PRN or TandE schedule in the second year. Twenty-eight eyes were treated according to the capped PRN regimen, and 23 eyes with the TandE regimen. In the first year those in the capped PRN group had visual acuity gains of +6 ETDRS letters compared with a mean gain of +8 ETDRS letters in the TandE group. At 2 years those in the TandE group lost -1 letter when compared with the 1-year outcomes, those in the capped PRN group remained stable in the Year 2. The TandE group had a mean of 5 monitoring visits versus 6 in the PRN study arm. At the end of the study the number of treatments were 5 in the TandE arm and 4 in the capped PRN group. The investigators concluded that the visual gain at the end of year one was maintained through the 2year treatment plan regardless of the treatment regimen used. Both capped PRN and Treat and Extend are proactive regimens that involve a higher number of IVIs, but would guarantee better VA score at the end of year 2.
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