First Author: A.Gkountelia UK
Co Author(s): A. Gkountelia P. Pacheco A. Ismail A. Kosmin M. Karampelas 0 0 0 0 0 0 0 0 0
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Age-related macular degeneration (AMD) is the leading cause of blindness among elderly patients in developed countries. Most recently, aflibercept was shown to be an effective treatment for neovascular AMD (nAMD), and a multi-centred randomized trial proved its non-inferiority compared to ranibizumab. The aim of this study was to report the outcomes of aflibercept treatment in a real-world clinical setting.
Medical Retina Department, Watford General Hospital, Watford, UK.
This is a retrospective study. Consecutive patients with nAMD treated in AMD treatment clinics of Watford General Hospital were evaluated. The inclusion criteria consisted of patients with nAMD managed with intravitreal aflibercept . The exclusion criteria included eyes with the presence of other retinal diseases likely to compromise visual acuity (VA). Patient records were reviewed and the following data were collected: age, follow-up period, best-corrected VA in ETDRS letters using the most up-to-date distance spectacle correction at each visit and optical coherence tomography derived central retinal thickness (CRT).
We assessed 30 eyes from 28 consecutive patients. Mean age was 82.8 years (range 55-93) and the mean follow-up was 4 months (range 3-5). Nine eyes (30%) had previous ranibizumab injections. At 3 months after first injection, 7 eyes had lost >5 letters (23.3%) and 23 eyes (76.7%) had gained >5 letters. CRT was decreased in 80% of eyes and the mean reduction was 137 μm (range 1-331). CRT was increased in 20% of eyes and the mean thickening was 114 μm (range 54-188). There was no statistically significant difference concerning change in VA and CRT between the treatment-naive eyes and eyes with previous ranibizumab injections.
Pivotal trials have demonstrated the efficacy of anti-vascular endothelial growth factor agents in the treatment of nAMD. However, concerns remain regarding how well outcomes in clinical practice can replicate those seen in clinical trials. Our preliminary results suggest that aflibercept treatment has favourable outcomes when is delivered in a clinical setting. In addition, aflibercept seems to be quite effective in eyes that were previously treated with ranibizumab .