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Changing from a pro re nata treatment regimen to a treat and extend regimen with ranibizumab in neovascular age-related macular degeneration
  1. Katja Hatz1,2,3,
  2. Christian Prünte1,2,3
  1. 1Vista Klinik, Binningen, Switzerland
  2. 2Department of Ophthalmology, Kantonsspital Liestal, Liestal, Switzerland
  3. 3University of Basel, Basel, Switzerland
  1. Correspondence to Professor Christian Prünte, Vista Klinik, Hauptstasse 55, Binningen CH-4102, Switzerland; christian{at}


Background Treat and extend (TE) treatment regimens have the potential to reduce the treatment burden placed upon patients receiving ranibizumab for neovascular age-related macular degeneration (nAMD). This study aimed to analyse changes in best corrected visual acuity (BCVA) and anatomical parameters in patients switching from a pro re nata (PRN) to a TE regimen during routine clinical practice.

Methods Retrospective, consecutive, comparative case series of treatment-naïve patients who were initially treated with 0.5 mg ranibizumab according to a PRN schedule, and subsequently switched to a TE schedule (12-month follow-up).

Results 146 eyes from 134 consecutive treatment-naïve patients were included. Mean BCVA (decimal±SD) increased from 0.39±0.23 to 0.55±0.22 (p<0.001) during the PRN loading regimen, declining to 0.49±0.22 (p<0.001) during the PRN maintenance phase (mean duration 17 months; range 3–55). Following the switch to TE, BCVA improved to 0.55±0.23 and 0.56±0.24 by 6 and 12 months, respectively (p<0.001). Mean intraindividual variance in BCVA was higher during the PRN phase than at 12 months for TE (0.30±0.18 vs 0.09±0.08, respectively; p<0.001). After switching to TE, mean central retinal thickness decreased from 355±112 µm to 330±105 and 320±103 µm at 6 and 12 months, respectively (p<0.001). Mean number of visits per month was higher during PRN than TE periods (1.05±0.13 vs 0.73±0.18; respectively; p<0.001).

Conclusions A TE regimen can improve and stabilise patient outcomes in nAMD compared with PRN, with the potential to reduce the healthcare resource burden incurred from fixed monitoring requirements.

  • Macula
  • Degeneration

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