Adrian T Fung, Nishant Kumar, Marcela Marsiglia,Sarah Mrejen, Jason Slakter, John Sorenson,K. Bailey Freund
To assess the efficacy of intravitrealaflibercept 2.0 mg in patients with treatment resistantneovascular age-related macular degeneration.
Retrospective analysis of eyes treated withaflibercept with persistent subretinal and/orintraretinal fluid despite previous treatments withintravitreal ranibizumab (0.5 mg). All patients wereswitched to intravitreal aflibercept (2.0 mg) andanalyzed following three consecutive injections andafter six months of treatment. Main outcome measuresincluded change in visual acuity, central foveal thick-ness (CFT) and the height and diameter of the pigmentepithelial detachment (PED).
There were 34 eyes of 33 patients analyzed.Mean duration of symptoms and average number ofprior injections with anti-vascular endothelial growthfactor agents was 44.7 ± 29.8 months (IQR 24–76) and28.6 ± 20.1 (IQR 10–47) respectively. At the six-monthfollow up, mean visual acuity and CFT improved sig-nificantly from 20/75 (logMAR 0.57 ± 0.36; IQR 0.30–1.0) and 416 ± 217 ?m (IQR 263–487) at baseline to20/60 (logMAR 0.47 ± 0.32; IQR 0.30–0.60) (p =0.004) and 248 ± 171 ?m (IQR 235–419) (p < 0.001).Maximum PED height improved significantly from260 ± 162 ?m (IQR 129–368) to 214 ± 142 ?m (IQR111–305) (p < 0.001) and PED diameter decreased sig-nificantly from 3265 ± 1622 ?m (IQR 2353–4555) to2949 ± 1653 ?m (IQR 1721–4484) (p = 0.04).
Intravitreal injections of aflibercept asignificantly improved visual and anatomic outcomesin eyes with persistent subfoveal fluid despite previoustreatment with ranibizumab.
COMPARISON OF RANIBIZUMAB AND AFLIBERCEPT IN PATIENTS WITH NEOVASCULAR AGE-RELATED MACULAR DEGENERATION TREATED FOLLOWING A ?TREAT AND EXTEND? PROTOCOL: EFFICACY VARIABLES FROM THE PRE-SPECIFIED 12- MONTH INTERIM ANALYSIS OF THE RIVAL STUDY