RPE atrophy in AMD patients switched from PRN to fixed anti-VEGF regimen

Session Details

Session Title: Free Paper Session 3: AMD I

Session Date/Time: Thursday 07/09/2017 | 08:30-10:00

Paper Time: 09:42

Venue: Room 118

First Author: : S.Teper POLAND

Co Author(s): :    J. Pilat   E. Wylegala                          

Abstract Details

Purpose:

To evaluate retinal pigment epithelium (RPE) atrophy in patients treated with fixed aflibercept regimen switched from pro re nata (PRN) regimen with different VEGF inhibitors.

Setting:

Clinical Dept. of Ophthalmology Medical University of Silesia, Katowice, Poland

Methods:

2-year retrospective evaluation of a neovascular age-related macular degeneration (AMD) cohort of 108 patients (122 eyes) treated with fixed 7 aflibercept injections per year in Polish AMD therapeutic program. Best corrected visual acuity (BCVA, number of letters on ETDRS charts) and imaging data including central retinal thickness (CRT) were evaluated for the period of 1 year of fixed regimen and 1 year before inclusion to the therapeutic program. Geographic atrophy (GA) de novo and increase in area of previously observed GA were assessed with fundus photography, swept-source optical coherence tomography and fundus autofluorescence. Multivariate analysis was employed.

Results:

Mean number of injections during first year of study was 2.9 +/- 1.1 and BCVA in this period decreased from 52.1+/-9.2 to 49.2+/-7.9. In the first year 61.5% of eyes were treated with bevacizumab alone while in 38.5% more than one anti-VEGF agent was used. BCVA increased to 55.4+/-9.1 letters at the end of the study. Incidence of GA de novo was 4.9% and 10.6% during first and second year respectively. Increase in GA area in patients with previously observed GA was seen in 25 vs. 48 eyes. Central involvement of GA was the main factor of decrease in BCVA during study. No significant difference was observed in CRT in the first year - 231+/-74 microns vs. 238+/-92 microns. CRT decreased to 168+/-83 microns at the end of the study.

Conclusions:

Despite higher progression of GA during fixed regimen treatment with aflibercept increase in BCVA can be expected when switched from PRN. It can be related to undertreatment which is common among PRN treated AMD patients.

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