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Chandra S, Gurudas S, Pearce I, Mckibbin M, Kotagiri A, Menon G, Burton BJL, Talks J, Grabowska A, Ghanchi F, Gale R, Giani A, Chong V, Chen CNT, Nicholson L, Thottarath S, Chandak S, Sivaprasad S. Baseline characteristics of eyes with early residual fluid post loading phase of aflibercept therapy in neovascular AMD: PRECISE study report 3. Eye (Lond) 2024; 38:1301-1307. [PMID: 38102473 PMCID: PMC11076629 DOI: 10.1038/s41433-023-02886-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 11/20/2023] [Accepted: 11/30/2023] [Indexed: 12/17/2023] Open
Abstract
PURPOSE To compare the baseline characteristics in patients with and without early residual fluid (ERF) after aflibercept loading phase (LP) in patients with treatment naïve neovascular age related macular degeneration (nAMD). METHODS Patients with nAMD initiated on LP of three intravitreal aflibercept doses were recruited from December 2019 to August 2021. Baseline demographic and OCT features associated with any ERF were analysed using Generalised Estimating Equations to account for inter-eye correlation. Receiver operating characteristic (ROC) curve was performed for selection of CST threshold. RESULTS Of 2128 patients enrolled, 1999 eyes of 1862 patients with complete data were included. After LP, ERF was present in 1000 (50.0%), eSRF in 746(37.3%) and eIRF in 428 (21.4%) eyes. In multivariable analysis of baseline features, eyes with increased central subfield thickness (CST) (OR 1.31 per 100 microns increase [95% CI 1.22 to 1.41]; P < 0.001), eyes with IRF and SRF at baseline (1.62 [95% CI 1.17 to 2.22]; P = 0.003), and those with SRF only (OR 2.26 [95% CI 1.59 to 3.20]; P < 0.001) relative to IRF only were determinants of ERF. CST ≥ 418 microns had 57% sensitivity and 58% specificity to distinguish ERF from no ERF at visit 4. CONCLUSION On average, 50% of eyes have ERF after aflibercept LP. Clinically relevant baseline determinants of ERF include CST ≥ 418 µ and presence of only SRF. These eyes may require further monthly treatment before extending treatment intervals.
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Affiliation(s)
- Shruti Chandra
- National Institute of Health Research Moorfields Biomedical Research Centre, Moorfields Eye Hospital, London, UK
- Institute of Ophthalmology, University College, London, UK
| | - Sarega Gurudas
- Institute of Ophthalmology, University College, London, UK
| | - Ian Pearce
- The Royal Liverpool and Broadgreen University Hospitals NHS Foundation Trust, Liverpool, UK
| | | | - Ajay Kotagiri
- South Tyneside and Sunderland NHS Foundation Trust, Sunderland, UK
| | - Geeta Menon
- Frimley Health NHS Foundation Trust, Surrey, UK
| | | | - James Talks
- Newcastle Hospitals NHS Foundation Trust, Newcastle, UK
| | - Anna Grabowska
- King's College Hospital NHS Foundation Trust, London, UK
| | - Faruque Ghanchi
- Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Richard Gale
- Hull York Medical School and York, University of York and Scarborough Teaching Hospital NHS Foundation Trust, York, UK
| | - Andrea Giani
- Boehringer Ingelheim, Binger Str. 173, 55216, Ingelheim am, Rhein, Germany
| | - Victor Chong
- Institute of Ophthalmology, University College, London, UK
| | | | - Luke Nicholson
- National Institute of Health Research Moorfields Biomedical Research Centre, Moorfields Eye Hospital, London, UK
| | - Sridevi Thottarath
- National Institute of Health Research Moorfields Biomedical Research Centre, Moorfields Eye Hospital, London, UK
| | - Swati Chandak
- National Institute of Health Research Moorfields Biomedical Research Centre, Moorfields Eye Hospital, London, UK
| | - Sobha Sivaprasad
- National Institute of Health Research Moorfields Biomedical Research Centre, Moorfields Eye Hospital, London, UK.
- Institute of Ophthalmology, University College, London, UK.
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