PurposeThe Observe-and-Plan (O&P) regimen allows for individualised treatment. In
this study, we evaluated injection burden and intervals using aflibercept in an O&P
regimen for eyes with neovascular age-related macular degeneration (AMD).MethodsThis
was a retrospective registry-based study of treatment-na & iuml;ve eyes with neovascular
AMD. Treatment data were compiled for 3 years after commencement of intravitreal aflibercept
therapy. We evaluated clinical consequences at the first follow-up after loading dose,
the proportion of patients who obtained and kept dry macula after loading dose, number
of injections and intervals between injections.ResultsData were obtained for 1103
eyes. After loading dose, 0.4% were lost to follow-up, 7.5% discontinued, 50.9% booked
for further injections and 41.3% booked for monthly observations. After loading dose,
the macula remained dry in 49.2% at 3 months, 34.0% at 6 months, 23.7% at 12 months
and 15.2% at 24 months. For the entire population, median cumulative total number
of injections was 7, 12 and 15, after 1, 2 and 3 years, respectively. After the 3rd
year, the proportion of eyes in the short 4-6 weeks treatment interval was 51.1%,
8 weeks interval was kept in 14.4% and the extended treatment intervals of 10 and
12 weeks was possible in 34.4%.ConclusionAfter loading dose, one in two eyes required
further injections. A large proportion required therapy with shorter intervals than
the label-recommended 8 weeks. The large majority of those who obtained a dry macula
after loading dose turned exudative again, mostly within the first 3 months.
