Switching to aflibercept from ranibizumab in choroidal neovascularization related to angioid streaks: a multicenter real life study

Abstract

Purpose : To evaluate the efficacy and the safety of Pro Re Nata (PRN) intravitreal aflibercept (Eylea; VEGF trap-Eye, Regeneron, Tarrytown and Bayer HealthCare, Berlin, Germany) in patients with refractory or recurrent choroidal neovascularization (CNV) secondary to angioid streaks (AS), previously treated by ranibizumab (Lucentis, Novartis Pharma SAS, Huningue, France; 0.5 mg in 0.05 m ).

Methods : Retrospective, multicenter study (n=3). Complete ophthalmic examination, best corrected visual acuity (BCVA), fluorescein angiography (FA), indocyanine green angiography (ICGA), central macular thickness (CMT) on spectral domain optical coherence tomography (SD-OCT), were collected. Patients were recorded into “refractory” (persistent exudation despite six monthly injections of ranibizumab) and “recurrent” groups (exudation suppressed, but requiring frequent injections with at least two recurrences during the last year before the switch).

Results : Twenty eyes of 16 patients (10 female, 67.3 ± 11.7 years old) were included. Mean follow up was 28.4 ± 8,7 months (range 13-41 months). Mean BVCA at baseline was 0.25 ± 0.33 logMAR and 0.35 ± 0.45 log MAR at the last visit (p 0.17). CMT was 321.8 ± 169.21 µm at baseline and 251.5 ± 63.34 µm at last follow up (p 0.067). Mean number of intravitreal injections of aflibercept was 12.27 ± 6.03. Four eyes were classified as “refractory” and 16 as “recurrent”. No adverse effect was observed.

Conclusions : Switching patients with CNV secondary to AS to aflibercept in a PRN schedule provided a stabilized vision and improved anatomic outcomes.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.