Nozomu Hashiya, Ichiro Maruko, Koji Tanaka, Junichiro Honjo, Yasunori Miyara, Yuto Watanabe, Ruka Maruko, Ayaka Nakai, Yu Wakatsuki, Kanako Itagaki, Marina Maehira, Nobuhiro Terao, Keiko Kataoka, Annabelle A. Okada, Hideki Koizumi, Ryo Mukai, Tetsuju Sekiryu, Ryusaburo Mori, Tomohiro Iida
PURPOSE: To evaluate 6-month outcomes of aflibercept 8 mg administered with two monthly injections followed by a treat-and-extend (TAE) regimen in treatment-naïve neovascular age-related macular degeneration (nAMD). STUDY DESIGN: Multicenter retrospective study. METHODS: This study included 107 treatment-naïve eyes with nAMD, of which 91 eyes of 90 patients (mean age, 74.7 ± 9.4 years) followed for 6 months were analyzed. All eyes received two consecutive monthly injections of aflibercept 8 mg (induction), followed by TAE. Best-corrected visual acuity (BCVA, logMAR), optical coherence tomography (OCT)-based anatomical outcomes, and adverse events were assessed. RESULTS: Sixteen eyes were excluded, mainly due to being lost-to-follow-up or having had treatment changed to an alternative drug. No serious adverse events were observed. Mean BCVA improved from 0.43 ± 0.36 at baseline to 0.37 ± 0.42 at 6 months (P = 0.032). Retinal thickness, pigment epithelial detachment height, and subfoveal choroidal thickness significantly improved (all P < 0.05). The mean number of injections over 6 months was 3.4 ± 0.5, and the mean treatment interval at the end of 6 months was 11.6 ± 2.2 weeks. A dry macula was achieved in 70.3% of eyes, with a higher rate in eyes achieving a dry macula after a two-injection induction than in those requiring a three-injection induction (80.0% vs 51.6%, P < 0.01). CONCLUSIONS: Eyes achieving a dry macula after two injections had higher 6-month dry rates than those requiring a third injection. Early treatment response may help predict treatment burden and guide individualized management strategies.