Abstract
Purpose:
To evaluate the early functional and anatomical responses to intravitreal aflibercept in patients with retinal angiomatous proliferation (RAP).
Methods:
This is a retrospective review of consecutive patients newly diagnosed with RAP, treated with intravitreal aflibercept (2mg). Patients were included if they fulfilled the requirements of the NICE guidelines on the use of aflibercept for the treatment of wet age-related macular degeneration (TA294). Patients were treated at baseline and at weeks 4, 8,16, 24 and 32, as per the protocol of the View 1 and 2 studies. Examination at each visit included ETDRS visual acuity and the measurement of the central macular thickness (CMT) using a standardised optical coherence tomography (OCT) protocol.
Results:
A total of 22 eyes of 21 patients (14 female, 7 male, mean age 83 years, range 70-94 ) with RAP at baseline (x stage 1, x stage 2) were treated. Compared to baseline (58 letters), the mean gain in visual acuity (ETDRS letters) was 7.5 letters at week 4, 7.1 letters at week 8, 7.5 letters at week 16, 11.0 letters at week 24 and 9.3 letters at week 32. Vision remained stable (± 15 letters of baseline) in 17/22 patients (77%). No patients lost >15 letters, while 5/22 gained >15 letters (23%) Compared with baseline (441 microns), the mean change in central macular thickness was -168 microns at week 4, -181microns at week 8, -160microns at week 16, -145 microns at week 24 and -162 microns at week 32. There were no cases of endophthalmitis during the study period.
Conclusions:
This study demonstrates that intravitreal aflibercept is an effective treatment for retinal angiomatous proliferation up to 32 weeks after treatment initiation. The results are similar to those of the pivotal View 1 and 2 studies, which examined the effectiveness of intravitreal aflibercept for treatment of all subtypes of choroidal neovascularisation associated with wet age-related macular degeneration