Abstract
Purpose :
To investigate 1-year visual and anatomic outcomes of intravitreal aflibercept for neovascular age-related macular degeneration (nAMD) given according to a fixed-interval dosing (Q8W).
Methods :
Retrospective, single-practice data analysis from an electronic medical record system. A total of 124 eyes (106 patients) with treatment-naïve nAMD receiving aflibercept every-8-weeks (Q8W) followed up for 1 year.
Results :
Mean age of patients was 82 years. 66 (53%) eyes showed occult with no classic CNV, 19 (15%) eyes showed predominantly classic lesions, 30 (24%) eyes showed a retinal angiomatous proliferation (RAP) lesion, whereas 3 eyes (2%) showed drusenoid PED with subretinal fluid (SRF) and corresponding leak on fluorescein angiography. Indocyanine-green angiography revealed polypoidal choroidal vasculopathy lesions in 6 (5%) eyes.
Mean LogMar best corrected visual acuity (BCVA) improved from 0.66 at baseline to 0.51 at month 11 (P < 0.0001). Mean central retinal thickness (CRT) decreased from 312.55 μm at baseline to 219.79 μm at month 11 (P < 0.0001). At month 11, 52 eyes (42%) were deemed inactive as defined by absence of intraretinal (IRF) or subretinal fluid on OCT, whereas 72 eyes (58%) remained active with the presence of SRF, IRF, intraretinal cysts, or macular haemorrhage.
Mean LogMar BCVA at month 11 for the active and inactive groups was 0.52 and 0.48 respectively (P=0.5225). Mean CRT at month 11 for the active and inactive groups was 240.18 μm and 190.70 μm respectively (P=0.0050). In 51 out of the 52 wet macula eyes (96%), the main feature was the presence of SRF.
Differences were not statistically significant (P=0.6418) when patients were stratified by age, LogMar BCVA, the top 25% (best BCVA) when compared with the bottom 25% (worst BCVA) in terms of active/inactive disease and when the top 25% (eldest patients) were compared to the bottom 25% (youngest patients) in terms of active/inactive disease (P=0.3411).
Conclusions :
Intravitreal aflibercept administered by Q8W fixed dosing over 1 year improved both visual acuity and macular morphology in a large number of treatment-naïve eyes with nAMD. Active lesions at month 11 do not have worse VA outcomes cf. inactive lesions. Treatment is effective irrespective of patients’ age and gender.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.