One year results of intravitreal aflibercept injection in the treatment of wet age related macular degeneration

Abstract

Purpose : The purpose of the study is to evaluate visual and anatomical outcome of intravitreal aflibercept in wet AMD after one year of treatment.

Methods : We reviewed retrospectively 88 eyes treated with intravitreal aflibercept (2mg) with at least 12 months of follow-up. Of these, 32 were naïve with no previous treatment and 56 were treated previously with intravitreal ranibizumab (0.5mg). Switcher eyes received more than 4 intravitreal injections of ranibizumab within 6 months on a pro renata regimen before conversion. All eyes received the 3 loading doses of aflibercept then followed every 4 weeks during 12 months. ETDRS visual acuity, slit lamp examination optical coherence tomography (OCT) were performed monthly, and patients were retreated as needed at the same visit. Fluorescein and Indocyanine Green Angiography were performed at baseline and 3 months. Statistical analysis was performed using SPSS.

Results : In naïves eyes (N=32), visual acuity improved from 59.3 letters to 64.4 letters. Reduction of central macular thickness was observed at M1, and then remained stable at 1 year (402µm vs 326µm at M1, 259 at M4, and 275µm, at M12). Subfoveal choroidal thickness did not change thorough 1 year. Mean number of Aflibercept injection was 7.2. Greatest linear diameter and surface area were stable after the loading phase (2.9mm vs 2.75mm; 5.8mm² vs 5.21 mm²⁾
In converted eyes, mean number of ranibizumab injection was 25 during a mean number of 29 months history duration. Visual gain was significant at M4 (62.10 to 64.1, p =0.4) and M6 and there was a trend to be significant at M12 (64.2 letters, p= 0.6). Thinning of central retinal thickness (344µm vs 286µm, <0.001), macular volume (8.1 to 7.9mm³, p= 0.002) was observed at M4 and at M12. Subfoveal choroidal thickness remained stable, and the height of PED decreased from 209µm to 176µm (p=0.001). Mean number of Aflibercept injection was 8.4 for 1 year.

Conclusions : In naives eyes, functional and anatomical improvement was observed with Aflibercept injections. Switching from ranibizumab was associated with anatomical improvement

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.