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Maria Eleftheriadou, Clara Vazquez-Alfageme, Maria Cristina Citu, Roxanne R Crosby-Nwaobi, Sobha Sivaprasad, Philip Hykin, Robin D Hamilton, Praveen J Patel; Efficacy of Aflibercept in Treatment-naïve Neovascular Age-related Macular Degeneration: Two-Year Real World Outcomes. Invest. Ophthalmol. Vis. Sci. 2016;57(12):3355. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To report 2 year, real-world visual and anatomical outcomes of aflibercept (Eylea® Bayer Pharma, Germany) treatment in patients with neovascular AMD (nAMD).
We performed a retrospective, observational study analysing 2-year treatment outcomes of aflibercept intravitreous injections in consecutively treated, treatment naïve eyes with nAMD in patients from all Moorfields Eye Hospital sites. Consecutive patients from October to December 2013, with 24±1 months follow up were included. Treatment was started following NICE (National Institute for Health and Care Excellence) guidance for funding treatment, which included best-corrected visual acuity (BCVA) between 24 and 73 ETDRS letters. Key exclusion criteria were: ≤4 intravitreal injections in year 1, ungradable OCT images, absence of OCT at baseline or final visit and concomitant ocular conditions affecting BCVA or macular anatomy. Aflibercept was administrated 2 monthly for the first year after 3 initial monthly injections, and in a treat and extend regimen for the second year. The primary outcome was the percentage of patients who maintained visual acuity (loss of < 15 ETDRS letters from baseline) at 2 years. Secondary outcomes included mean change in BCVA, change in central macular thickness (CMT), gain of ≥15 letters and percentage of patients with signs of active disease (macular fluid) on OCT imaging, determined by single grader at 2 years.
Of 129 patients, 43 eyes of 43 patients (33.3%) satisfied the inclusion criteria, with incomplete follow-up (n=35, 40.7%) the key reason for exclusion. At 1 year, 88,4% of patients maintained visual acuity with a mean gain in VA of 8.7±16.4 letters and a mean reduction in CMT of 102.9± 102.5µm. 47.5% had active disease in the OCT at year 1. At 2 years, 90.7% of patients maintained visual acuity, with an average of 12.3 (±3.8) injections. The mean gain in VA was 7.8 ±16.1 letters with a mean reduction in CMT of 103.0 ± 115.0 µm at 2 years. 25.6% gained a minimum of 15 letters. 27.9% showed signs of active disease on OCT imaging at the end of 2 year follow-up.
Aflibercept use for nAMD in routine clinical practice resulted in comparable visual outcomes after 2 years to outcomes seen in the 96 week extension phase results from the VIEW clinical trials.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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