June 2015
Volume 56, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2015
Clinical efficacy of aflibercept in non responsive to ranibizumab choroidal neovascular lesions in AMD
Author Affiliations & Notes
  • Simone Donati
    Department of Surgical and Morphological Sciences - Section of Ophthalmology, University of Insubria, Varese, Italy
  • Jennifer Cattaneo
    Department of Surgical and Morphological Sciences - Section of Ophthalmology, University of Insubria, Varese, Italy
  • Marco Bianchi
    Department of Surgical and Morphological Sciences - Section of Ophthalmology, University of Insubria, Varese, Italy
  • Simona Maria Caprani
    Department of Surgical and Morphological Sciences - Section of Ophthalmology, University of Insubria, Varese, Italy
  • Carlo Gandolfi
    Department of Surgical and Morphological Sciences - Section of Ophthalmology, University of Insubria, Varese, Italy
  • Laura Premoli
    Department of Surgical and Morphological Sciences - Section of Ophthalmology, University of Insubria, Varese, Italy
  • Riccardo Vinciguerra
    Department of Surgical and Morphological Sciences - Section of Ophthalmology, University of Insubria, Varese, Italy
  • Francesco Testa
    Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, Second University of Naples, 80121 Naples, Italy, Napoli, Italy
  • Claudio Azzolini
    Department of Surgical and Morphological Sciences - Section of Ophthalmology, University of Insubria, Varese, Italy
  • Footnotes
    Commercial Relationships Simone Donati, None; Jennifer Cattaneo, None; Marco Bianchi, None; Simona Maria Caprani, None; Carlo Gandolfi, None; Laura Premoli, None; Riccardo Vinciguerra, None; Francesco Testa, None; Claudio Azzolini, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2015, Vol.56, 4585. doi:
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      Simone Donati, Jennifer Cattaneo, Marco Bianchi, Simona Maria Caprani, Carlo Gandolfi, Laura Premoli, Riccardo Vinciguerra, Francesco Testa, Claudio Azzolini; Clinical efficacy of aflibercept in non responsive to ranibizumab choroidal neovascular lesions in AMD. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):4585.

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

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Abstract
 
Purpose
 

To evaluate the efficacy of aflibecept to modify the activity of CNV non responder to ranibizumab. To evaluate the variation in morphological and functional parameters after a loading phase of a different antiVEGF agent.

 
Methods
 

This prospective study included 15 eyes of 15 consecutive patients affected by CNV secondary to AMD, defined non responder to ranibizumab treatment. We included different active CNV lesions: 5 occult CNV, 7 fibrovascular DEP, 3 RAP lesions. Exclusion criteria were defined to avoid bias as extensive macular hemorrhages or lesion fibrosis, DEP with extended RIP, lesion with fibrovascular scars larger more than 2DA, patients who underwent to more than 8 ranibizumab injections. Patients at baseline were evaluated with complete ophthalmological examination, retinal angiography and SD OCT. A scheduled control visit was performed at month 4 after the aflibercept loading phase, to evaluate morphological and functional changes. A statistical analysis has been performed to evaluate the considered variables.

 
Results
 

Clinical evaluation showed interesting results about functional and morphological modifications. Mean visual acuity significantly increased from of 0,86 ± 0,29 LogMAR to 0,52±0,23 LogMAR, 6 patients reported a reduction in metamorphopsia, 5 patients a reduction in the intensity of the central scotoma. Mean retinal thickness significantly decreased from 425,54±15,16µm to 275,00±104,50µm; a reabsorption of subretinal fluid was reported in 10 patients, a reduction and disappearance of intraretinal edema and cysts was evident in 12 patients. Pigment epithelium detachment elevation was reduced in 5 of 7 patients. A significant reduction of angiographic activity was perceivable in 9 of 15 lesion studied.

 
Conclusions
 

Alfibercept appeared to be effective in modifying the natural history of ranibizumab non responders lesions. After a loading phase, morphological and functional features improved because of better control of the pathology. A longer follow up would be necessary to evaluate a long term effectiveness of the new antiVEGF agent. OCT exam appeared to be the better way to follow the lesion activity and its modifications.

 
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