Efficacy of intravitreal aflibercept up to 1 year

Abstract

Purpose: We reported previously that of all treatment-naïve age-related macular degeneration (AMD) patients, 80% well-responded to aflibercept induction therapy by achieving complete resolution of the fluid. Yet 40% of these eyes aflibercept-dependently recurred requiring repeated injections (2013 ARVO). We basically applied bimonthly treatment in drug-dependent cases or PRN in non-dependent cases and followed the efficacy of aflibercept treatment in AMD patients up to 1 year.

Methods: Medical records of 90 eyes of 84 AMD patients who received initial three monthly intravitreal aflibercept (IVA) induction therapy in our clinic from Feb to Oct 2013 were reviewed. After completion of induction therapy, naïve well-responded eyes were treated on a PRN regimen, whereas naïve insufficient-responded, early relapsed eyes (IVA-dependent), and converted from intravitreal ranibizumab (IVR) eyes (IVR-dependent) were treated with bimonthly IVA. We thereby studied the visual acuity (VA), the central retinal thickness (CRT) and the incidence of dry macula at 1year.

Results: Of 90 eyes, 70 eyes (77.8%; naïve 30/41 eyes:73%, converted from IVR 40/49 eyes :82%) well responded to the induction therapy. Forty three eyes (47.7%) continued bimonthly IVA including 4 eyes that were converted from PRN due to early relapse (IVA-dependent), and 47 eyes (52.3%) were treated by additional IVA on a PRN regimen (average additional injection of the first year:1.4). The logMAR VA was 0.609 at baseline, then improved significantly to 0.516 at 3 months (M) and 0.542 at 12M (P<0.05). The CRT was 430.0μm at baseline, then also improved significantly to 267.8μm at 3M, 274.3μm at 12M (P<0.05). The incidence of dry macula was 28/43 eyes (65%) in eyes treated bimonthly and 27/47 eyes (57%) in eyes treated on a PRN regimen.<br />

Conclusions: Eighty percent of AMD patients well-responded to aflibercept induction therapy by achieving complete resolution of the fluid and VA improved up to 12 M, though the incidence of dry macula was 65% in eyes treated bimonthly and 57% in eyes treated on a PRN regimen.