First Author: J.Chhablani INDIA
Co Author(s): I. Braimah K. Agarwal A. Mansour
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To evaluate 12-month outcome of intravitreal ziv-aflibercept (IVZ) therapy in eyes with neovascular age related macular degeneration (nAMD), that are non-responsive to bevacizumab and ranibizumab.
Tertiary eye care centre
This retrospective study included 16 eyes (14 patients) with nAMD who were on prior treatment with bevacizumab and ranibizumab and were treated with as-needed IVZ (1.25mg/0.05ml) for 12 months. The primary outcome measure was the mean change in best corrected visual acuity (BCVA) and secondary outcome measures included mean change in central macular thickness (CMT), retinal pigment epithelial detachment (RPED) heights, longest treatment free interval, presence of subretinal fluid (SRF) and intraretinal fluid (IRF), and adverse events.
There was no change in the mean logarithm of minimum angle of resolution (LogMAR) BCVA at baseline and following treatment with IVZ therapy (p=0.978). The mean number of IVZ injections during 12 months was 5.9±3.3 and the mean number of anti-VEGF (vascular endothelial growth factors) injections prior to switching to IVZ was 8.4± 4.7. The mean treatment free interval was longer during IVZ therapy (114.4±67.1 days) compared to 76.3±54.6 days before IVZ therapy (p=0.03). Five (31.25%) eyes had visual gains of at least 0.1 LogMAR, 3 (18.75%) eyes had stable BCVA (within 0.1 LogMAR) and 8 (50%) eyes had BCVA decline of at least 0.1 LogMAR. There was no significant difference in the mean CMT, RPED heights and presence of IRF and SRF at 12 months compared to baseline. No adverse events were noted.
Intravitreal ziv-aflibercept increased the treatment free interval in nonresponders but no significant change in visual and anatomic outcomes.