June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
Conversion to aflibercept for chronic refractory or recurrent neovascular age-related macular degeneration
Author Affiliations & Notes
  • Yoshihiro Yonekawa
    Massachusetts Eye and Ear Infirmary, Boston, MA
  • John Miller
    Massachusetts Eye and Ear Infirmary, Boston, MA
  • John Loewenstein
    Massachusetts Eye and Ear Infirmary, Boston, MA
  • Lucia Sobrin
    Massachusetts Eye and Ear Infirmary, Boston, MA
  • Dean Eliott
    Massachusetts Eye and Ear Infirmary, Boston, MA
  • Demetrios Vavvas
    Massachusetts Eye and Ear Infirmary, Boston, MA
  • Joan Miller
    Massachusetts Eye and Ear Infirmary, Boston, MA
  • Christopher Andreoli
    Massachusetts Eye and Ear Infirmary, Boston, MA
    Harvard Vanguard Medical Associates, Boston, MA
  • Ivana Kim
    Massachusetts Eye and Ear Infirmary, Boston, MA
  • Footnotes
    Commercial Relationships Yoshihiro Yonekawa, None; John Miller, None; John Loewenstein, None; Lucia Sobrin, None; Dean Eliott, Genentech (C), Regeneron (C), Ophthotech (C), Alcon (C), Bausch & Lomb (C), Allergan (C), Alimera (C), Acucela (C), Arctic (C), Salutaris (C); Demetrios Vavvas, MEEI (P), Kala pharmaceuticals (C), Roche (C), Genentech (C); Joan Miller, Massachusetts Eye and Ear Infirmary (P), Novartis (I), Alcon (C), KalVista Pharmaceuticals (C); Christopher Andreoli, None; Ivana Kim, Genentech (F), SalutarisMD (C), Genzyme (C), ArticDx (C), Sequenom (C)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 1938. doi:
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      Yoshihiro Yonekawa, John Miller, John Loewenstein, Lucia Sobrin, Dean Eliott, Demetrios Vavvas, Joan Miller, Christopher Andreoli, Ivana Kim; Conversion to aflibercept for chronic refractory or recurrent neovascular age-related macular degeneration. Invest. Ophthalmol. Vis. Sci. 2013;54(15):1938.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: To examine the outcomes of patients with refractory or recurrent neovascular age-related macular degeneration who were converted from bevacizumab and/or ranibizumab to aflibercept intravitreal injections.

Methods: This was a two-center, retrospective, interventional, non-comparative series. Treatment histories, visual acuity (VA), and central macular thickness (CMT) on spectral-domain OCT were collected. Patients were divided into “refractory” (those with persistent exudation despite monthly injections) or “recurrent” (those who required repeated injections to maintain a dry macula).

Results: 102 eyes of 94 patients were included in the study. 68 were refractory, and 34 were recurrent. A mean of 20.4 prior bevacizumab/ranibizumab injections and a mean of 3.8 aflibercept injections were administered. Mean follow-up was 18 weeks. Mean VAs were: 20/50-1 before conversion, 20/50-2 after 1 aflibercept injection (P = .723), and 20/50+2 after the final injection (P = .253). Subgroup analysis of refractory and recurrent cases also showed stable VA. Of the refractory cases, mean CMT improved after 1 injection (P < .001) and the final injection (P < .001). Intraretinal (P < .001) and subretinal (P < .001) fluid decreased after 1 injection, and the mean injection interval could be extended from 5.2 to 6.2 weeks (P = .003). Of the recurrent cases, mean CMT improved after 1 injection (P < .001) and the final injection (P < .001). Intraretinal (P = .003) and subretinal (P = .046) fluid decreased after 1 injection, and the mean injection interval could be extended from 7.2 to 9.5 weeks (P = .001).

Conclusions: Converting patients with chronic neovascular AMD to aflibercept may result in stabilized vision and improved anatomical outcomes, while allowing injection intervals to be extended.

Keywords: 412 age-related macular degeneration  
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