April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
Response of Pigment Epithelial Detachments following Intravitreal Aflibercept for Age-Related Macular Degeneration
Thomas Hong; Geoffrey Broadhead; Meidong Zhu; Haitao Li; Timothy Schlub; Wijeyanthy Wijeyakumar; Andrew Alexander Chang
Author Affiliations & Notes
  • Thomas Hong
    Sydney Institute of Vision Science, Sydney, NSW, Australia
    Sydney Retina Clinic and Day Surgery, Sydney, NSW, Australia
  • Geoffrey Broadhead
    Sydney Institute of Vision Science, Sydney, NSW, Australia
    Sydney Retina Clinic and Day Surgery, Sydney, NSW, Australia
  • Meidong Zhu
    Sydney Institute of Vision Science, Sydney, NSW, Australia
    Sydney Retina Clinic and Day Surgery, Sydney, NSW, Australia
  • Haitao Li
    Sydney Institute of Vision Science, Sydney, NSW, Australia
    Sydney Retina Clinic and Day Surgery, Sydney, NSW, Australia
  • Timothy Schlub
    Sydney Institute of Vision Science, Sydney, NSW, Australia
  • Wijeyanthy Wijeyakumar
    Sydney Institute of Vision Science, Sydney, NSW, Australia
    Sydney Retina Clinic and Day Surgery, Sydney, NSW, Australia
  • Andrew Alexander Chang
    Sydney Institute of Vision Science, Sydney, NSW, Australia
    Sydney Retina Clinic and Day Surgery, Sydney, NSW, Australia
  • Footnotes
    Commercial Relationships Thomas Hong, None; Geoffrey Broadhead, None; Meidong Zhu, None; Haitao Li, None; Timothy Schlub, None; Wijeyanthy Wijeyakumar, None; Andrew Chang, Alcon (C), Bayer (C), Bayer (F), Bayer (R), Novartis (C), Novartis (R)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 3937. doi:
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      Thomas Hong, Geoffrey Broadhead, Meidong Zhu, Haitao Li, Timothy Schlub, Wijeyanthy Wijeyakumar, Andrew Alexander Chang; Response of Pigment Epithelial Detachments following Intravitreal Aflibercept for Age-Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2014;55(13):3937.

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Abstract

Purpose: To assess the response of pigment epithelial detachments (PEDs) to intravitreal aflibercept in patients with refractory neo-vascular age-related macular degeneration (nAMD) over 12 months.

Methods: 43 patients with PED participating in a prospective trial for nAMD received 3 loading injections of intravitreal aflibercept 4 weeks apart followed by injections every 8 weeks across 48 weeks. All patients underwent monthly ophthalmic examination including best-corrected visual acuity (BCVA) and spectral-domain optical coherence tomography (SD-OCT) to measure central macular thickness (CMT). PED size was measured at each visit in 3 dimensions: maximum width, height and length. Mean change was assessed between baseline and week 48 in each dimension. PEDs were categorised by location in relation to the fovea (sub/juxta and extrafoveal). Three types of PEDs were graded based on SD-OCT reflectivity signal under the retinal pigment epithelium (RPE): predominantly hyper-reflective signal below the RPE (solid), predominantly hypo-reflective signal below the RPE (hollow) and a combination of solid and hollow (mixed). Correlations between change in PED size and changes in BCVA and CMT were assessed.

Results: At week 48, mean maximum PED height, width and length reduced significantly (-53.5µm, -276.8µm and -301.9µm, respectively) when compared to baseline (p<0.01 for all). Complete PED resolution occurred in 4 patients (9.3%) over the 12 month period. A reduction in all 3 individual PED dimensions were significantly correlated with a reduction in CMT (p<0.01) but not BCVA (p>0.05). Thirty four (79%) PED were subfoveal/juxta and 9 (21%) were extrafoveal. Patients with extrafoveal PED had a greater reduction in PED height compared to patients with subfoveal/juxta PED (p=0.05). Twenty-one (49%) PED were solid, 13 (30%) were hollow and 9 (21%) were mixed. Patients with hollow PED and mixed PED had a greater reduction in all 3 individual PED dimensions compared to solid PED (p<0.05 for all).

Conclusions: Intravitreal aflibercept was effective in reducing PED size in patients with nAMD and was correlated with a reduction in CMT. Aflibercept achieved complete PED resolution in 9.3% of patients, with a trend towards hollow, extrafoveal PED being the most responsive to therapy.

Keywords: 412 age-related macular degeneration • 466 clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials • 688 retina  
© 2014, The Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Permission to republish any abstract or part of an abstract in any form must be obtained in writing from the ARVO Office prior to publication.
Copyright © 2024 Association for Research in Vision and Ophthalmology.
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