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Frank Becquet, Jean-François Le Rouic, Idriss Badat, Elisabeth Hermouet-Leclerc, Caroline Pousset-Decré, Axelle Alphandari, Pascal Peronnet; Treatment of Exudative Age Related Macular Degeneration with aflibercept in a French Private Institution : from the lauching period to a one year follow-up.. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):4615.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the main reason for aflibercept prescription in exudative age related macular degeneration (wAMD) during the launching period in France and to assess the outcome of treated eyes.
Retrospective analysis of the charts of 313 eyes of 284 consecutive patients treated for the first time with aflibercept for wAMD during a 16-week period starting at the date of availability of aflibercept in france (November 2013). Analyzed criteria were : main reason for aflibercept prescription, previous history of anti-VEGF injection, initial visual acuity and optical tomography (OCT) results and outcome.
90 % of included eyes had previously been treated with ranibizumab. Median previous anti-VEGF treatment duration was 20 months (range 1-95) and median number of injections was 12 (range 1-55) . Unsatisfactory results with ranibizumab (60 %) and the expectation of a longer duration effect of aflibercept (35%) were the most common reasons for aflibercept prescription.<br /> At one year, 11 % of patients were lost to follow-up ; the death rate was 1 % (3 patients). 280 eyes (74%) had been solely treated with aflibercept during the study period. At the last visit, a visual improvement (≥ 3 lines) was noted in 14 eyes (4,4%) and a visual loss in 20 eyes (6,4%) ; on OCT the retina was dry in 143 eyes (46%). 64 eyes (20%) were switched to ranibizumab. In 62 of these eyes (97%) the OCT disclosed persistent exudation before switching.
During the launching period, the majority of eyes treated with aflibercept were previously treated with ranibizumab and had unsatisfactory results. Aflibercept treatment mainly provided a stabilization of the vision. The switch toward ranibizumab was mosty guided by OCT results rather than visual changes.
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