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David Sayag, Mayer Srour, Oudy Semoun, Neda Abraham, Vincent Pierre-Kahn; Long term visual and anatomic outcomes of switching to Aflibercept for neovascular AMD : 2 years results.. Invest. Ophthalmol. Vis. Sci. 2017;58(8):440. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To report interim 2-year visual and anatomic outcomes of intravitreal aflibercept for neovascular age-related macular degeneration (AMD) in patients recurrent or refractory to ranibizumab.
This is a retrospective review of eyes with neovascular AMD with at least 2 years of follow-up after the switch. All Patients has had a minimum of 3 injections of ranibizumab before the switch. Aflibercept was used in recurrent or refractory patients to ranibizumab. Changes in best corrected visual acuity ( BVCA), fluid ,central retinal thickness , anatomic outcome of ellipsoid ( , retinal pigment epithelium (RPE) and external limiting membrane (ELM) on optical coherence tomography (OCT) were described .Frequency of injections were also analyzed
125 eyes on110 patients were studied. Mean age of patients was 79 years . Before switching, patients had received a mean of 7,7 injections of ranibizumab (3-30). At baseline BCVA was 49,9 letters and the mean CRT 388,3 µm. 153 (87%) eyes showed a pigment epithelial detachment. Intraretinal fluid (IFR) was present in 59 % of eyes. Sub-retinal fluid was present in 65% of eyes. mean follow up duration after the first injection of aflibercept was 24 months. One year after the switch, an interim analysis shows a nonsignificant increase of + 2,3 letters (p=0,454) with a mean number of 3,9 Aflibercept injections (65 eyes analyzed) and a mean change in CRT of -59,5 µm (p<0,0001 ; 145 eyes analyzed). Two years after the switch, an interim analysis shows a mean change in visual acuity of -0,3 letters (p=0,633) with a mean of 6,1 injections of aflibercept and a mean change in CRT of -76,1 µm (p<0,0001 ; 55 eyes analyzed). At 24 months, ELM and RPE disruption were shown in 75% and 63% without correlation with final BVCA.
Two years after a switch to aflibercept for nAMD in patients recurrent or refractory to ranibizumab, an interim analysis shows that visual acuity was stabilized and CRT had a significant improvement (p<0,0001). Moreover ELM and RPE disruption are frequent after long term switching clinical practice
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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