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Intravitreal aflibercept for the treatment of wet age related macular degeneration: one year experience from the Western Eye Hospital

Session Details

Session Title: AMD III

Session Date/Time: Sunday 20/09/2015 | 11:00-13:00

Paper Time: 12:12

Venue: Athena

First Author: : A.Savastano UNITED KINGDOM

Co Author(s): :                  

Abstract Details

PURPOSE:to report the morpho-functional results of Aflibercept (Eylea) intravitreal injection (A-IVI) for wet age related macular degeneration (w-AMD).

Setting:

Retrospective interventional case series / Western Eye Hospital - Imperial College - London

Methods:

we retrospectively examined 26 eyes of 26 patients (14 male and 12 female; mean age 80.5; range age 63-91) with a follow-up of 14 months, treated for w-AMD. All the eyes examined, did not receive any type of intra-vitreal anti vascular endothelial growth factor (anti-VEGF) before Aflibercept. The morphological analyses included the Optical Coherence Tomography (HD-OCT; Carl Zeiss Meditec, Dublin, CA, USA), Fluoroangiography (Topcon retinal camera, IMAGEnet inc.) while the functional assessment included the best correct visual acuity (BCVA - logarithm of the minimum angle of resolution [LogMar]). The timing of the follow-up was: baseline, 3, 6, 12 months. Every patient received 8 A-IVI according to the protocol (first 3 monthly A-IVI followed by an A-IVI every two months for the first year, regardless the activity of the disease as the guidelines suggested). Statistical analysis were performed using ANOVA test.

Results:

at the end of the follow-up, 61.5% (16 eyes) improved the BCVA, 23.1% remained stable and 15.4% had a worsening of the BCVA (p-Value < 0,02%). All the patients have had a significantly reduction of the central macular thickness at month 12 (p-Value < 0,02%) at the automatic OCT measurement (improvement or resolution of the intra-retinal fluid or sub-retinal fluid). In the eyes we observed a worsening of the VA at the end of the follow-up (15.4%), a retinal scar development was detectable at the OCT even though the macula in these eyes resulted dry.

Conclusions:

the one-year results of A-IVI for w-AMD are statistically significant to improve (61.5%) or to stabilize (23.1%) the visual acuity from the baseline. The VA worsening in the 15.4% of the eyes could be due to the particular aggressivity of the neo-vascular membrane or to the late stage of the disease at the time of the observation and treatment. In fact we observed that the eyes that have had the best VA outcome were those which received an early diagnosis and respective early treatment. From our experience, with 12 months follow-up, A-IVI resulted a valid treatment for w-AMD in patient who did not receive previous intra-vitreal anti-VEGF treatment. A long-term follow-up will be useful to evaluate the stability of the treatment.

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