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Filofteia Tacea, Cristina Schiesser, Tara Rajhbeharrysingh, Venkat Kotamarthi; Results of switch patients from Ranibizumab to Aflibercept in chronically active choroidal neovascular membrane (CNVM). Invest. Ophthalmol. Vis. Sci. 2018;59(9):2400.
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To evaluate the number of patients treated with Aflibercept in the switch group from Ranibizumab in one-stop clinic who had signs of active disease after loading dose and again at the beginning of the second year of treatment.
Retrospective review of 100 patients treated with Aflibercept in the switch group from Ranibizumab was performed using electronic medical records (MediSOFT® software). All patients had the loading dose of 3 injections of Aflibercept every 4 weeks followed by 4 injections 8 weekly in the first year.ETDRS visual acuity tests (VA) and Spectral Domain Optical Coherence Tomography (SD-OCT) were recorded at each visit.
18 (18%) patients out of 100 had sub-optimal response with persisting fluid confirmed by SD-OCT and 12 (12%) had decreased VA of ≥ 5 ETDRS letters. Six patients whose VA remained unaffected were maintained at 8 weekly treatment. 12 patients required frequent injections, 8 of them had 6 weekly treatment and 4 of them had 4 weekly injections on 3 occasions. The later had no fluid confirmed by SD-OCT and VA has been restored to previous level. They were successfully extended to 8 weekly.In the second year, 14 eyes (14%) had persisting fluid and a decrease in VA of ≥ 5 ETDRS letters was seen in 6 eyes. All of them had Aflibercept reduced to 4 weekly on 3 occasions. The group of 6 eyes who had decreased VA ≥ 5 ETDRS letters required 3 more injections of Aflibercept every 6 weeks until no fluid was present on the SD-OCT and VA was restored to previous level. Subsequently all the patients were extended beyond 8 weekly intervals.
We have successfully achieved no fluid on SD-OCT in patients with chronically active CNVM by decreasing the intervals between the Aflibercept for a short period and subsequently, extend it gradually to 8 then 10 and 12 weeks.
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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