July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Results of switch patients from Ranibizumab to Aflibercept in chronically active choroidal neovascular membrane (CNVM)
Author Affiliations & Notes
  • Filofteia Tacea
    Ophthalmology, Leighton Hospital, Ewloe, ENGLAND, United Kingdom
  • Cristina Schiesser
    Ophthalmology, Leighton Hospital, Ewloe, ENGLAND, United Kingdom
  • Tara Rajhbeharrysingh
    Ophthalmology, Leighton Hospital, Ewloe, ENGLAND, United Kingdom
  • Venkat Kotamarthi
    Ophthalmology, Leighton Hospital, Ewloe, ENGLAND, United Kingdom
  • Footnotes
    Commercial Relationships   Filofteia Tacea, None; Cristina Schiesser, None; Tara Rajhbeharrysingh, None; Venkat Kotamarthi, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 2400. doi:
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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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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : 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.

Methods : 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.

Results : 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.

Conclusions : 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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