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Bora Chae, Irene Barbazetto, Roberto Gallego-Pinazo, Samir Patel; Long-term anatomical and functional outcomes after switch to aflibercept therapy for neovascular age-related macular degeneration. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):4588.
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To study long-term outcomes in patients previously receiving antiVEGF therapy with bevacizumab (Avastin™, Genentech) and/or ranibizumab (Lucentis™, Genentech) and switched to aflibercept (Eylea™, Regeneron) for treating neovascular age-related macular degeneration (AMD).
A retrospective chart review was performed of patients with neovascular AMD treated with intravitreal bevacizumab and/or ranibizumab and switched to aflibercept. Best corrected visual acuity (VA), central macular thickness (CMT), and OCT findings were evaluated before the switch and compared to results after 3, 6, and 24 months.
57 eyes of 45 patients (22 females, 23 males; average±SD age 82±7.6 years) were included in the study. Eyes had an average number of 15±2.9 injections at 24 months. Mean VA at baseline, 3, 6, and 12 months were 0.64±0.5, 0.58±0.45, 0.6±0.4 and 0.6±0.5 (logMAR), respectively. There was no statistically significant difference in VA between baseline and any of the follow-up examinations.. Mean CMT at baseline, 3, 6, and 24 months were 329.91±87.4, 297.58±66.3, 303.86 ±71.6, and 302.41±70.3, respectively. There was a statistically significant difference between CMT at baseline versus CMT at 6 months (p=0.008), and between baseline versus 24 months (p=0.025). There was no statistically significant difference between CMT at 6 months versus CMT at 24 months (p=0.983). Mean CMT difference between baseline versus 6 months was significantly associated with VA improvement observed between baseline versus 6 months by t-test analysis (p=0.031). Twenty-one of 57 eyes (37%) showed an improvement of 1 line (0.1 logMAR) or more at 6 months and 34 of 57 eyes (60%) had an improvement in CMT by an average of 55.4 (±60.2) μm during the same time. Of the 21 eyes with improvement in VA, 17 (81%) of them were associated with improvement in CMT. In this cohort, 14 of 19 eyes (74%) sustained (n=8) or continued to improve (n=6) their visual acuity and 21 of 32 eyes (66%) maintained (n=12) or showed improvement (n=9) in CMT at 24 months.
Anatomical and functional improvements were sustained in the majority of patients switched to aflibercept from other antiVEGF agents. While patients who were switched to aflibercept did not experience a significant VA improvement at short or long-term follow up, they did experience a statistically significant improvement in CMT.
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