July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
One-year real-world outcome in patients receiving individualized treatment with aflibercept for neovascular age-related macular degeneration
Author Affiliations & Notes
  • Mya Thida Ohn
    Ophthalmology, Southend University Hospital, Leigh-on-Sea, United Kingdom
  • Footnotes
    Commercial Relationships   Mya Ohn, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 799. doi:
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      Mya Thida Ohn; One-year real-world outcome in patients receiving individualized treatment with aflibercept for neovascular age-related macular degeneration. Invest. Ophthalmol. Vis. Sci. 2018;59(9):799.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To identify one year visual outcome of intravitreal aflibercept injection and number of injections required for neovascular age-related macular degeneration (AMD) by providing individualized treatment (given injections as required) after series of three loading doses.

Methods : Retrospective single-practice data analysis after reviewing electronic medical records of all new cases of neovascular AMD diagnosed within three months. Patients received treatment with intravitreal Aflibercept injection. Visual acuity was recorded by ETDRS chart and activity of AMD was identified by using OCT and slit lamp.

In each visit, patients were reviewed by an ophthalmologist. Patients were reviewed two monthly after three loading doses. Patients had OCT scan at each visit and underwent treatment if required. The unit provided one stop service.

Results : Total 82 eyes were studied. Males females ratio was 1:2.4 and average age of patients was 77.77. Mean best corrected visual acuity at initial presentation was 57.88 letters and at month eleven was 64.29 and 63.11 letters at month thirteen. Visual gain was 6.41 letters at month eleven and 5.23 at month thirteen. 53% of eyes had active disease at month thirteen. Mean number of clinic visits was 7.89 and mean number of injections was 5.29.

Conclusions : Neovascular age-related macular degeneration has been treated with aflibercept mostly by using fixed regime for the initial one year. VIEW 1 and VIEW 2 studies have shown outstanding results (7.9 letters gain in VIEW 1 and 8.9 letters gain in VIEW 2) and one year fixed-dosing with seven visits single unit data has shown 8 letters gain. However, evidence of data in view of as required treatment, disease activity and possible adverse effect of retinal thinning by over treatment with anti-VEGF is lacking. Moreover, national audit data set of one year outcomes of Aflibercept injection for neovascular AMD has proved average visual gain of 5.1 letters. A multi centered real-world study of ranibizumab injection for AMD has also proved visual gain in real-world could be different from landmark studies.

Our study has achieved visual gain comparable with the national audit data. Mean number of injections required was 1.71 less than fixed-dosing and national audit data. This number might not be significant but might be important in view of risk of endophthalmitis for each injection.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

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