Abstract
Purpose :
Purpose: To examine the two year efficacy of intravitreal aflibercept (Eylea) in patients with wet age-related macular degeneration (AMD), and the efficacy of intravitreal Afilbercept in patients that were previously non-responsive to intravitreal Ranibizumab (Lucentis).
Methods :
Methods: This is an on-going, comparative, interventional case series comparing two years of data. All cases of wet AMD were treated with Aflibercept (Eylea), one group treated from the outset and the other, that were previously non-responsive to intravitreal Ranibizumab were switched to intravitreal aflibercept.
Results :
Results: Approximately 234 eyes were treated with anti VEGF. In the first cohort 135 eyes, were from the start, treated with purely Aflibercept (Eylea) during the study period (July 2013 to December 2016). The mean age was 77.0±8.1years. In the treatment ‘naïve’ group (Eylea only) - at presentation the mean baseline (pre-treatment) BCVA was 55.4 ± 15.1 letters, with a mean gain of 1.1 ± 11.4 letters at 12th months (p=0.320). Twenty-four month data is currently being collated and analysed.
The mean pre-treatment central macular thickness (CMT) was 333.6 ± 113.3 µm with a mean reduction of 83.3±94.3 µm at 12 months (p<0.001) and a reduction of 50±42.6 µm at 24 months (provisional two-year data - currently in progress).
In the switched group (initially on Ranibizumab then switched to Eylea) approximately 94 patients were treated. The mean age was 75.5 ± 7.3 years. An average of 13.9 ± 8.3 intravitreal ranibizumab injections (Lucentis) were given before switching to intravitreal Aflibercept (Eylea). The baseline best-corrected visual acuity (BCVA) on first presentation was 60.9 ± 11.6 letter. Initial mean central macular thickness (CMT) pre-aflibercept was 343 ± 127 μm. The BCVA on switching from ranibizumab to aflibercept was 55.6 ± 14.6 letters, with a mean change of -5.8 letters (p<0.001). At 12-month post aflibercept, there was a mean change of -0.3 letters (p=0.82). Central macula thickness was reduced by approximately 75 μm at 12 months (p<0.001) and 63 μm at 24months (provisional data).
No complications were noted during the study period.
Conclusions :
Conclusions: Our study demonstrates that aflibercept serves as an effective and safe alternative treatment of wet AMD and offers good efficacy over an extended period of time.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.