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. 2022 Jan 7;7(1):e000930.
doi: 10.1136/bmjophth-2021-000930. eCollection 2022.

Patient satisfaction following a switch from treat-and-extend to observe-and-plan regimen in age-related macular degeneration

Tora Sund Morken  1   2 , Christina Knutsen  3 , Margrete Sætre Hanssen  1   2 , Dordi Austeng  1   2
Affiliations

Patient satisfaction following a switch from treat-and-extend to observe-and-plan regimen in age-related macular degeneration

Tora Sund Morken et al. BMJ Open Ophthalmol. .

Abstract

Objective: Standard treatment of neovascular age-related macular degeneration (nAMD) is intravitreal injections (IVI) of antivascular endothelial growth factor (anti-VEGF) according to treat-and-extend (TnE). Observe-and-plan (OnP), a new regimen based on each individual's relapse interval lead to fewer clinical visits and has so far shown to be safe in treatment-naïve patients. In this study, we explore patient satisfaction and safety in nAMD when switching from TnE to OnP.

Methods and analysis: 38 participants treated acording to TnE for ≥12 months were included and switched from TnE to OnP with their last stable interval. Main outcome was patient satisfaction (Leeds Satisfaction Questionnaire). Secondary outcomes were best-corrected visual acuity (BCVA), central retinal thickness (CRT) before and 12 months after switch and number of monitoring visits and injections of anti-VEGF 12 months prior to and following switch.

Results: Mean patient satisfaction was higher (3.7±0.5 SD) at 12 months after switch from TnE to OnP than before (3.6±0.5 SD, p=0.009, response rate 76%). BCVA and CRT were unchanged. Number of monitoring visits and injections were lower in the 12 months following than prior to switch (p<0.001).

Conclusion: A switch from TnE to OnP in a non-treatment-naïve population resulted in higher patient satisfaction, while maintaining stable BCVA. This indicates that OnP may be applicable in the large group of nAMD patients that have received IVI for several years. OnP may alleviate the treatment burden on both individual and society of frequent clinical visits while increasing patient satisfaction.

Keywords: degeneration; drugs; macula; retina; treatment medical.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Switch of treatment protocol from treat and extend to observe and plan. Prior to switch participants with neovascular age-related macular degeneration had been receiveing anti-VEGF treatment for a minimal amount of 12±1 months. VEGF, vascular endothelial growth factor.
See this image and copyright information in PMC

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