July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Three year real world outcomes of aflibercept treatment for wet age-related macular degeneration and results of variable treatment regimes in the second year.
Author Affiliations & Notes
  • Sajjad Mahmood
    Manchester Royal Eye Hospital, Manchester, United Kingdom
    University of Manchester, Manchester, United Kingdom
  • Zaria Christine Ali
    Manchester Royal Eye Hospital, Manchester, United Kingdom
  • Tariq Mehmood Aslam
    Manchester Royal Eye Hospital, Manchester, United Kingdom
    University of Manchester, Manchester, United Kingdom
  • Konstantinos Balaskas
    NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
    University of Manchester, Manchester, United Kingdom
  • Footnotes
    Commercial Relationships   Sajjad Mahmood, Bayer (R), Novartis (R); Zaria Ali, None; Tariq Aslam, Bayer (R), Novartis (R); Konstantinos Balaskas, Bayer (R), Novartis (R), Novartis (C)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 2390. doi:https://doi.org/
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      Sajjad Mahmood, Zaria Christine Ali, Tariq Mehmood Aslam, Konstantinos Balaskas; Three year real world outcomes of aflibercept treatment for wet age-related macular degeneration and results of variable treatment regimes in the second year.. Invest. Ophthalmol. Vis. Sci. 2018;59(9):2390. doi: https://doi.org/.

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

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Abstract

Purpose : To report three year real world outcomes of aflibercept treatment in neovascular age related macular degeneration (nAMD) and visual results for patients following variable treatment regimes in the second year according to disease activity.

Methods : A retrospective study was carried out of patient data in an electronic patient record. Treatment naive patients diagnosed with nAMD and treated with aflibercept for at least one year were included. In the first year treated was according to the product label.
In the second year patients were treated according to four subgroups dependent on their treatment response in the first year. In group 1 due to a very good response treatment was stopped and patients monitored, group 2 continued treatment on a treat and extend basis, group 3 continued bimonthly treatment and group 4 underwent treatment intensification.

Results : 640 patients were included. 38.2% were male, and 61.8% were female. Mean age was 78.1 years. Mean baseline vision was 54.7 ETDRS letters, with a mean change at 12 months of +5.3 letters and 32 months of +3.7 letters.
Before treatment 19.1% of the full cohort achieved a vision of 70 letters or more. At the end of 12 months this increased to 32.0%, and reduced to 26.7% by the end of year 3.
In the full cohort, the mean number of injections administered each year fell from 6.8 in year 1, to 4.6 in year 2 and 4.3 in year 3.
Group 1 required a mean of 2.6 injections in the second year and visual acuity dropped slightly 57.5 to 55.6 letters.
Group 2 required a mean of 4.8 injections in the second year and visual acuity remained stable, 58.9 to 59.0 letters.
Group 3 required a mean of 5.4 injections in the second year and visual acuity remained stable 60.9 to 60.6 letters.
Group 4 required a mean of 7.7 injections in the second year and visual acuity dropped from 60.8 to 54.6 letters.

Conclusions : Good visual outcomes are achieved with aflibercept in nAMD patients over the course of three years. Stable vision is achieved in patients managed with a treat and extend or bimonthly regime. Patients who are monitored maintain an overall visual gain compared to baseline but suffer a small drop in vision in year two. Visual loss is also seen in in patients requiring treatment intensification.

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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