September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Evaluation of the efficiency of intravitreal Aflibercept in patients affected with Occult Choroidal Neovascularisation (OCNV), Polypoidal Choroidal Vasculopathy (IPVC) and Retinal Angiomatous Proliferation (RAP) previously treated with intravitreal Ranibizumab
Author Affiliations & Notes
  • Simona Altimari
    San Giovanni Evangelista Hospital, Tivoli, Italy
  • Roberta Salvati
    San Giovanni Evangelista Hospital, Tivoli, Italy
  • Luigi Zompatori
    San Giovanni Evangelista Hospital, Tivoli, Italy
  • Footnotes
    Commercial Relationships   Simona Altimari, None; Roberta Salvati, None; Luigi Zompatori, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 3347. doi:
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      Simona Altimari, Roberta Salvati, Luigi Zompatori; Evaluation of the efficiency of intravitreal Aflibercept in patients affected with Occult Choroidal Neovascularisation (OCNV), Polypoidal Choroidal Vasculopathy (IPVC) and Retinal Angiomatous Proliferation (RAP) previously treated with intravitreal Ranibizumab. Invest. Ophthalmol. Vis. Sci. 2016;57(12):3347.

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

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Abstract

Purpose : To evaluate the efficiency of Aflibercept in cases of wet AMD that responded less successfully to treatment with Ranibizumab

Methods : 21 were selected, 6 of whom were affected by Occult CNV, 8 by IPVC and 7 by RAP. All patients had been previously treated with Intravitreal (IVT) Ranibizumab (one IVT per month for the first 3 months with successive treatments PRN) and then were shifted to 3 consecutive IVT treatments for the first 3 months with Aflibercept and successively every two months for the remainder of the first year. We evaluated visual acuity (VA) by ETDRS and central thickness (CT) by SD-OCT examination at the moment of the shift (t0) and successively each month up to 12 months (t2)

Results : At 12 months from the shift all of the patients involved in the study presented a significant improvement in the OCT; the average thickness for all three groups decreased from 392.93 µ to 287.66 µ (p<0.02), while the average variation of VA increased from 30.54 letters to 33.33 letters. These, however, are not are not statistically significant (p>0.02).
Analysis of the three subgroups shows that, regarding VA, all patients presented variations that were not statistically significant but that tended to remain stable. This was most likely due to the EPR conditions and for the junction lines between SE and SI of the photoreceptors which were already compromised in many of the patients at the moment of the shift: the patients with Occult CNV progressed from 29.83 to 35.66 letters (p>0.02); the IPVC group went from 31.37 to 32.87 letters, while the RAP group from 30.42 to 31.14 letters. The CT variations with OCT showed a reduction in all three groups which indicates a statistically significant improvement (p<0.02); the group with Occult CNV went from an average thickness of 370.5 to 257.33 µ, the IPVC group from 409.87 to 308.37 and the RAP group from 398.42 to 297.28

Conclusions : From the results it is clear that treatment with Aflibercept (0.05 ml/2.0 mg) in patients who were non-respondent to Ranibizumab leads to significant improvement of the central retinal thickness observable with OCT. Instead, visual acuity tends to remain stable, in this case probably because of EPR impairment and the photoreceptors present at the moment of the shift

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

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