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Kimberly Spooner, Thomas Hong, Rashmi Nair, Nicholas Chian Chiang Chow, Geoffrey Broadhead, Wijeyanthy Wijeyakumar, Andrew Chang; LONG-TERM OUTCOMES OF SWITCHING TO AFLIBERCEPT FOR TREATMENT RESISTANT NEOVASCULAR AGE-RELATED MACULAR DEGENERATION. Invest. Ophthalmol. Vis. Sci. 2018;59(9):820.
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© ARVO (1962-2015); The Authors (2016-present)
To report 4-year outcomes following the switch to aflibercept in treatment resistant neovascular age related macular degeneration (nAMD)
This prospective, open-label, non-controlled, clinical trial recruited forty-nine patients with treatment resistant nAMD, who received 2mg intravitreal aflibercept as 3 loading doses every 4 weeks, followed by injections every 2 months for the first 12-months, then treat and extend regimen for a further 36-months. Patients were assessed for best corrected visual acuity (BCVA), central retinal thickness (CRT) measured with SD-OCT, geographic atrophy surface area (GA) as measured on autofluorescence and occurrence of adverse events at every visit.
Of the 49 patients who were initially recruited, data from 39 patients were available at 48-month follow-up. Mean age was 76.74 ± 7.19 years. Over the 48 months, these eyes received a mean of 32.10 ± 5.56 injections. The mean BCVA improved significantly following 12 months of treatment (4.87 ± 8.96 ETDRS letters, p<0.001), however this was not maintained and was similar to baseline after 48 months (mean difference -0.44 ± 13.29 letters between baseline and 48 months, p<0.001). The reduction in CRT from baseline was 170.26 ± 143.28µm (p<0.001) with absence of macular fluid in 56% of the 39 eyes at the end of month 48. GA increased by a mean of 4.71 ± 4.03mm2 (p=0.071) over the 48-months.
Aflibercept is an effective alternative therapy for treatment resistant nAMD. Good anatomical and stable functional response are achievable with continued therapy. The lack of continued visual gains may be representative of GA progression, reflecting the advanced nature of disease in these patients.
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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