Abstract
Purpose:
To assess the functional and morphological outcome in patients with chronic recurrent neovascular age-related macular degeneration (nvAMD) previously treated with ranibizumab, who were either switched from ranibizumab to aflibercept or received further ranibizumab injections.
Methods:
Retrospective analysis of eyes that had received ≥3 injections of ranibizumab previously, with ≥1 injection during the preceding 365 days. Patients were divided in 2 groups; one had received 3 injections of aflibercept (2.0mg), the other ranibizumab (0.5mg), at 4 weeks intervals. Main outcome measures included change in visual acuity (VA) in logMAR, subfoveal central retinal thickness (CRT), subretinal fluid (SRF) and height of pigment epithelial detachment (PED height) as well as maximum height of macular subretinal fluid (SRF max) and of macular pigment epithelial detachment (PED height max) on spectral-domain optical coherence tomography (OCT). Changes in VA and OCT were compared between both groups to investigate differences in the therapeutic effects of aflibercept and ranibizumab.
Results:
60 eyes of 55 patients were included. The aflibercept group (AG) (n=30) and the ranibizumab group (RG) (n=30) showed no statistically significant differences regarding mean age (p=0.813), number of prior injections with ranibizumab (p=0.127) or time period since last injection (p=0.523). Mean VA logMAR improved in both groups, though only in the ranibizumab group the difference was statistically significant (0.50±0.33 to 0.44±0.29 logMAR; p=0.013). CRT decreased in the aflibercept (p=0.133) and in the ranibizumab group (p=0.043). PED height was reduced in both groups (AG p=0.068; RG p=0.241). SRF, SRF max and PED height max showed statistically significant decrease in both groups. A comparison of the aflibercept and the ranibizumab group showed no statistically significant differences in change of VA logMAR (p=0.680), CRT (p=0.882), SRF (p=0.871), PED height (p=0.524), SRF max (p=0.940) or PED height max (p=0.762) between the two groups.
Conclusions:
Aflibercept and ranibizumab were similarly effective in improving visual acuity and morphological parameters of patients with recurrent nvAMD after four months. There were no statistically significant differences in the therapeutic effects of the two drugs compared in this sample.
Keywords: 412 age-related macular degeneration •
462 clinical (human) or epidemiologic studies: outcomes/complications