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Thi Ha Chau Tran, Awatif Barakat, Said BOUAKAZ, Bertrand Delepine; Early results of intravitreal aflibercept for wet age-related macular degeneration (AMD) in clinical practice. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):4616.
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© ARVO (1962-2015); The Authors (2016-present)
The purpose of the study is to evaluate visual and anatomical outcome of intravitreal aflibercept in wet AMD
We reviewed retrospectively 86 eyes treated with intravitreal aflibercept (2mg) with at least 6 months of follow-up. Of these, 32 were naïve with no previous treatment and 54 were treated previously with intravitreal ranibizumab (0.5mg). Switcher eyes received more than 4 intravitreal injections of ranibizumab within 6 months on a pro renata regimen before conversion. All eyes received 2mg of aflibercept at baseline, month 1 and month 2. Early Treatment Diabetic Retinopathy (ETDRS) best corrected visual acuity, spectral domain optical coherence tomography (OCT) were performed monthly, and patients were retreated as needed at the same visit from month 3 to month 6. Fluorescein and Indocyanine Green Angiography were performed at baseline and month 3. Since the number of naïve patients was too small to drawn any conclusion, we concentrated on the patients converted to aflibercept
At baseline, 54 converted eyes with a mean of 24 prior ranibizumab intravitreal injections had a mean of 61.6 letters and mean central macular thickness of 347.6µm. ETDRS letters improved to 62.4 at month 1 (p=0.2), 64.6 at month 3 (p=0.02) and 65 at month 6 (p=0.06). Reduction of central macular thickness was observed at month 1 (292µm, p = 0.001) though month 6 (35µm,p= 0.03). Height of PED decreased from baseline (213µm) to month 1 (186µm, p= 0.007) through month 6 (196µm,p= 0.029). No patient lost > 15 letters
Mild improvement in visual acuity was achieved in switcher eyes from ranibizumab to aflibercept. Aflibercept 2mg led to significant anatomic improvement after 3 loading doses and pro renata retreatement. Further study is needed to elucidate maintain of visual and anatomic improvement in the long term.
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