June 2015
Volume 56, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2015
Effects of Switching from Ranibizumab to Aflibercept on Visual Outcome, Lesion Activity and Treatment Intensity in Eyes with Neovascular Age-Related Macular Degeneration
Author Affiliations & Notes
  • Daniel Barthelmes
    Ophthalmology, University Hospital Zurich, Zurich, Switzerland
    Save Sight Institute, Clinical Ophthalmology, The University of Sydney, Sydney, NSW, Australia
  • Anna E Campain
    Save Sight Institute, Clinical Ophthalmology, The University of Sydney, Sydney, NSW, Australia
  • Jennifer J Arnold
    Marsden Eye Specialists, Parramatta, NSW, Australia
  • Ian McAllister
    The Lions Eye Institute, University of Western Australia, Perth, WA, Australia
  • Judy M Simpson
    Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
  • Alex P Hunyor
    Retina Associates, Chatswood, NSW, Australia
  • Robyn H Guymer
    Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, University of Melbourne, Melbourne, VIC, Australia
  • Rohan W Essex
    Department of Ophthalmology, Canberra Hospital, Canberra, ACT, Australia
  • Nigel Morlet
    Department of Population Health, University of Western Australia, Perth, WA, Australia
  • Mark C Gillies
    Save Sight Institute, Clinical Ophthalmology, The University of Sydney, Sydney, NSW, Australia
  • Footnotes
    Commercial Relationships Daniel Barthelmes, None; Anna Campain, None; Jennifer Arnold, None; Ian McAllister, None; Judy Simpson, None; Alex Hunyor, None; Robyn Guymer, None; Rohan Essex, None; Nigel Morlet, None; Mark Gillies, None
  • Footnotes
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Investigative Ophthalmology & Visual Science June 2015, Vol.56, 4589. doi:
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      Daniel Barthelmes, Anna E Campain, Jennifer J Arnold, Ian McAllister, Judy M Simpson, Alex P Hunyor, Robyn H Guymer, Rohan W Essex, Nigel Morlet, Mark C Gillies; Effects of Switching from Ranibizumab to Aflibercept on Visual Outcome, Lesion Activity and Treatment Intensity in Eyes with Neovascular Age-Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):4589.

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

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Abstract

Purpose: To evaluate the effect of changing from ranibizumab to aflibercept in eyes with neovascular age-related macular degeneration (nAMD) on visual acuity, lesion activity and the interval of time between treatments.

Methods: Observational longitudinal study using anonymized data from patients treated for nAMD. Visual acuity (VA) was recorded at each visit using the logarithm of the Minimum Angle of Resolution (logMAR) letter score. For each treated eye an index visit was defined as the visit when treatment for nAMD was commenced. Visual acuity, lesion activity and treatment given were recorded for each follow-up visit. Decision to treat was made by the treating physician, thus reflecting daily clinical practice. Only eyes with nAMD that changed from ranibizumab to aflibercept treatment were included. Eyes that switched treatments were required to have been on the original treatment for at least 12 months, and then followed for an additional 12 months post treatment switch. We compared VA at the time of the switch with VA 12 months after treatment change, and compared the treatment intensity and lesion activity in the 12 months before and the 12 months after the switch.

Results: A total of 381 eyes were analyzed. The mean VA at the time treatment was switched was 64.4 logMAR letters, mean VA 12 months later was 63.8 logMAR letters. The difference was statistically not different. Prior to treatment change eyes received more injections compared with after: there was a mean of 8.1 treatments within 12 months prior to switch, this reduced to 7.4 injections in 12 months post switch (p<0.001). There was a significant decrease in the proportion of CNV activity of switching eyes: at the point of treatment change 78% of eyes had an active CNV reading, after 12 months this proportion had dropped to 55% (p<0.001).

Conclusions: Changing from ranibizumab to aflibercept treatment in nAMD may result in a reduced treatment load in<br /> some eyes. However the influence of the additional time under treatment on overall treatment load warrants further investigation.

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