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Analysis of the effects of aflibercept in chronic neovascular age-related macular degeneration previously treated with bevacizumab or ranibizumab

Session Details

Session Title: Quick Fire Free Paper 3

Session Date/Time: Thursday 11/09/2014 | 14:30-16:00

Paper Time: 14:40

Venue: Boulevard D

First Author: : J.Pinheiro-Costa PORTUGAL

Co Author(s): :    J.M. Costa   J. Beato   P. Freitas-da-Costa   M.S. Falcão   F. Falcão-Reis   A.M. Carneiro

Abstract Details

Purpose:

To report the clinical outcomes of intravitreal aflibercept therapy in eyes with neovascular AMD switched from intravitreal bevacizumab or ranibizumab.

Setting:

Department of Ophthalmology of Hospital de São João, Porto, Portugal.

Methods:

A retrospective review of 86 eyes treated in a 1+PRN regimen in a clinical setting with bevacizumab or ranibizumab that were switched to aflibercept. Aflibercept was used in patients considered refractory to bevacizumab (persistent exudation despite consecutive injections) – group 1, and in patients on therapy with ranibizumab due to an institutional policy decision (controlled with exudation suppressed, but requiring frequent injections) – group 2. Changes in best-corrected visual acuity (BCVA), anatomic response with the switch, central retinal thickness (CRT) and frequency of injections were compared.

Results:

Eighty six eyes of 69 patients were analyzed; 39 eyes in group 1 and 47 in group 2. Mean follow-up time was 18 months prior to the switch and 5.9 months with aflibercept. Visual acuity showed stability with therapeutic switch in both groups (group1: 58.2 and 58.4, p=0.900; group2: 55.5 and 55.1, p=0.725) and the mean number of injections per month was significantly lower (0.753 vs 0.649, p=0.030). With the switch to aflibercept, 89.5% of patients showed anatomic improvement with reduction of intra and/or subretinal fluid and both groups presented significant improvement in CRT (Group 1, 68.5 µm (p=0.040); Group 2, 85.0 µm (p < 0.001)).

Conclusions:

Switching patients with neovascular AMD from bevacizumab or ranibizumab to aflibercept results in anatomical improvement and stabilized vision, while allowing injection intervals to be extended.

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