Abstract
Purpose:
To evaluate the main reason for aflibercept prescription in exudative age related macular degeneration (wAMD) during the launching period in France and to assess the outcome of treated eyes.
Methods:
Retrospective analysis of the charts of 313 eyes of 284 consecutive patients treated for the first time with aflibercept for wAMD during a 16-week period starting at the date of availability of aflibercept in france (November 2013). Analyzed criteria were : main reason for aflibercept prescription, previous history of anti-VEGF injection, initial visual acuity and optical tomography (OCT) results and outcome.
Results:
90 % of included eyes had previously been treated with ranibizumab. Median previous anti-VEGF treatment duration was 20 months (range 1-95) and median number of injections was 12 (range 1-55) . Unsatisfactory results with ranibizumab (60 %) and the expectation of a longer duration effect of aflibercept (35%) were the most common reasons for aflibercept prescription.<br /> At one year, 11 % of patients were lost to follow-up ; the death rate was 1 % (3 patients). 280 eyes (74%) had been solely treated with aflibercept during the study period. At the last visit, a visual improvement (≥ 3 lines) was noted in 14 eyes (4,4%) and a visual loss in 20 eyes (6,4%) ; on OCT the retina was dry in 143 eyes (46%). 64 eyes (20%) were switched to ranibizumab. In 62 of these eyes (97%) the OCT disclosed persistent exudation before switching.
Conclusions:
During the launching period, the majority of eyes treated with aflibercept were previously treated with ranibizumab and had unsatisfactory results. Aflibercept treatment mainly provided a stabilization of the vision. The switch toward ranibizumab was mosty guided by OCT results rather than visual changes.