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Background <p>Neovascular age-related macular degeneration (nAMD) with type 3 macular neovascularisation (MNV) carries a high risk of macular atrophy (MA) during anti-vascular endothelial growth factor (anti-VEGF) treatment. Previous studies have suggested that a greater injection burden is associated with a higher MA risk. We evaluated 2-year outcomes of patients with nAMD with type 3 MNV following the treat and extend (TAE) and pro re nata (PRN) regimens and identified the risk factors for MA.</p> Subjects <p>This retrospective study included 97 eyes of 68 treatment-naïve nAMD patients with type 3 MNV. All eyes received monthly anti-VEGF injections for 3 months as a loading phase and were followed for &gt;2 years. Analyses were performed at the eye level for clinical outcomes; for risk-factor analyses of incident MA, one eye per patient was included. Outcomes included best-corrected visual acuity (BCVA) and central macular thickness (CMT).</p> Results <p>Compared with PRN, TAE achieved better BCVA at 24 months (mean difference, −0.26 logMAR; 95% CI, −0.50 to −0.02). CMT was lower with TAE at 12 months (mean difference, −47.0 µm; 95% CI, −86.1 to −8.0). Retinal haemorrhage recurrence was less frequent with TAE (16.4% vs. 52.4%; risk difference, −36.0%; 95% CI, −57.8% to −9.5%). In multivariable models, greater injection number and thinner baseline central choroidal thickness were associated with incident MA (<i>P</i> &lt; 0.05), whereas regimen type itself was not.</p> Conclusions <p>Despite a higher injection burden, TAE maintained superior functional outcomes over two years relative to PRN.</p>

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Two-year treatment outcomes in neovascular age-related macular degeneration with type 3 macular neovascularisation

  • 期刊论文

  • 发表日期：

    2026年5月22日

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  • Yosuke Fukuda,
  • Satomi Shiose,
  • Shoji Notomi,
  • Yusuke Maehara,
  • Kodai Yuge,
  • Kohei Kiyohara,
  • Yuta Yasaka,
  • Kenichiro Mori,
  • Kohta Fujiwara,
  • Kumiko Kano,
  • Keijiro Ishikawa,
  • Yusuke Murakami,
  • Koh-Hei Sonoda

摘要

Background

Neovascular age-related macular degeneration (nAMD) with type 3 macular neovascularisation (MNV) carries a high risk of macular atrophy (MA) during anti-vascular endothelial growth factor (anti-VEGF) treatment. Previous studies have suggested that a greater injection burden is associated with a higher MA risk. We evaluated 2-year outcomes of patients with nAMD with type 3 MNV following the treat and extend (TAE) and pro re nata (PRN) regimens and identified the risk factors for MA.

Subjects

This retrospective study included 97 eyes of 68 treatment-naïve nAMD patients with type 3 MNV. All eyes received monthly anti-VEGF injections for 3 months as a loading phase and were followed for >2 years. Analyses were performed at the eye level for clinical outcomes; for risk-factor analyses of incident MA, one eye per patient was included. Outcomes included best-corrected visual acuity (BCVA) and central macular thickness (CMT).

Results

Compared with PRN, TAE achieved better BCVA at 24 months (mean difference, −0.26 logMAR; 95% CI, −0.50 to −0.02). CMT was lower with TAE at 12 months (mean difference, −47.0 µm; 95% CI, −86.1 to −8.0). Retinal haemorrhage recurrence was less frequent with TAE (16.4% vs. 52.4%; risk difference, −36.0%; 95% CI, −57.8% to −9.5%). In multivariable models, greater injection number and thinner baseline central choroidal thickness were associated with incident MA (P < 0.05), whereas regimen type itself was not.

Conclusions

Despite a higher injection burden, TAE maintained superior functional outcomes over two years relative to PRN.