First Author: S.Burgula UK
Co Author(s): G. De La Mata M. Gkika K. Tsaousis
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To Investigate of efficacy and safety of treatment of Neovascular Age-related Macula Degeneration (AMD) with intravitreal Aflibercept
Leicester Royal Infirmary, Leicester, UK
This is a retrospective study based on an audit regarding neovascular AMD cases treated with Aflibercept over a 12 month period as per relevant protocol . Inclusion criteria included: Age >50 years, subfoveal choroidal neovascular (CNV) lesions secondary to AMD or juxtafoveal lesions affecting the fovea, BCVA more than or equal to 1.2 on LogMAR scale. In all cases course of treatment of 3 monthly injections followed by 4 bi-monthly injections of 2mg/0.01 ml Aflibercept were completed. Exclusion criteria were prior treatment with anti-VEGF therapy and incomplete injections schedule as per protocol. Patients were examined before treatment initiation followed by bi-monthly visits. Each visit included best corrected visual acuity (BCVA) assessment on LogMAR scale and anterior/posterior segment examination. Optical coherence tomography (OCT) scan was performed using time domain Stratus machine. The primary outcome of this study was to determine proportion of patients maintaining vision (Change of <0.3 LogMAR) at week 52.Secondary outcomes included mean change in BCVA which was defined as loss or gain of >0.3 on LogMAR scale. Also, changes on OCT , that is, reduction of central retinal thickness (CRT) and persistence of fluid were also recorded. Potential complications of endophthalmitis, thromboembolic events were recorded
This study included 35 eyes of 33 patients receiving intravitreal 2mg/0.05ml of Aflibercept. There were 17 males and 18 females with mean age of 80.47 years. The Mean BCVA was 0.65 on LogMAR scale. OCT features included mean Central retinal thickness (CRT) as 351.53 microns. Primary outcome: Overall 85.7% (n=30) eyes had maintained vision at the end of treatment. Secondary outcomes: There was vision gain in 11.4% (n=4)of eyes. Percentage of vision loss was 2.8% (n=1) which was due to sub-macular haemorrhage. There was a mean reduction of CRT by 120 microns. There was no case of endophthalmitis
On comparison of our audit results with VIEW 1,2 standards, the primary outcome was achieved.Hence ,Aflibercept is effective in treatment of Wet AMD. However, the percentage of vision gain was lower than standard protocol. Therefore, we recommend further analysis of CNV lesions to determine the cause for lower proportion of visual gain.