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Lucia Finocchio, Ilaria Biagini, Giovanni Giacomelli, Francesco Attanasio, Barbara Giambene, Rita Mencucci, Alessandro Franchini, Gianni Virgili, Stanislao Rizzo; INTRAVITREAL AFLIBERCEPT IN THE TREATMENT OF NAIVE NEOVASCULAR MEMBRANES IN AGE-RELATED MACULAR DEGENERATION: SHORT TERM EXPERIENCE IN CLINICAL PRACTICE. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):2853.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the short term outcome of intravitreal aflibercept as first-line therapy in the treatment of naïve choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD).
Retrospective, non comparative case series. Best corrected ETDRS visual acuity (VA), OCT central macular thickness (CMT) and lesion size and type analysis with fluorescein angiography were recorded at baseline, 3 and 6 months. We administered three monthly injections and a single additional injection after at least one month in case persistence or recurrence were seen with clinical and OCT examination.
100 eyes of 96 patients with a mean age of 78.3 years (SD:7.3) were enrolled, in whom classic (n.31) or occult (n.58) CNV was detected, while 11 eyes had retinal angiomatous proliferation (RAP); 65 lesions were subfoveal and 35 extra- or juxtafoveal.<br /> Overall, mean baseline VA non-significantly improved from 0.52 logMAR at baseline to 0.49 logMAR at 3-months (p=0.138), and returned to baseline value (0.52 logMAR) at 6 months (p=0.982). Mean central macular thickness (CMT) decreased from 311 μm at baseline to 248 μm at 3-months follow-up and 261 μm at 6-months visit (P<0.001 for both times).<br /> Eyes with VA 0.5 logMAR or worse (n.54) gained -0.07 logMAR at 3 months (p=0.003) and -0.047 logMAR at 6 months (p=0.191). Eyes with VA better than 0.5 logMAR (n.46) non-significantly worsened by 0.026 logMAR at 3 month (p=0.308) and 0.054 logMAR at 0.6 months (p=0.166), and did significantly worse than those with better VA (p=0.020). Mean VA did not vary by lesion type (p=0.956) and location (p=0.182).<br /> There were 5 eyes with persistence at 3 months and 15 with recurrence at 5 months.
Intravitreal aflibercept treatment of patients with neovascular AMD and a variety of lesions was effective in maintaining baseline VA and in reducing CMT up to 6 months of follow-up. Standard bimonthly treatment may be advisable for patients with higher visual acuity to try to maintain or improve vision.
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