Session Title: AMD III
Session Date/Time: Sunday 20/09/2015 | 11:00-13:00
Paper Time: 12:36
First Author: : S.Donati ITALY
Co Author(s): : J. Cattaneo M. Bianchi S. Caprani L. Premoli C. Azzolini
PURPOSE:To evaluate the efficacy of a therapeutical switch to alfibercept in non responders patients. To
evaluate the variation in OCT morphological and functional parameters.
Department of Surgical and Morphological Sciences - Section of Ophthalmology, University of Insubria, Varese, Italy.
This prospective study included 16 eyes of 16 consecutive patients affected by CNV secondary to AMD, defined non responder to ranibizumab treatment. We included different active CNV lesions: 5 occult CNV, 7 fibrovascular DEP, 3 RAP lesions. Exclusion criteria were defined to avoid bias as extensive macular hemorrhages or lesion fibrosis, DEP with extended RIP, lesion with fibrovascular scars larger more than 2DA, patients who underwent to more than 8 ranibizumab injections. Patients at baseline were evaluated with complete ophthalmological examination, retinal angiography and SD OCT. A scheduled control visit was performed at month 4 after the aflibercept loading phase, to evaluate morphological and functional changes. A statistical analysis has been performed to evaluate the considered variables.
Clinical evaluation showed interesting results about functional and morphological modifications. Mean visual acuity remained stable from 0,59 ± 0,23 LogMAR to 0,51±0,23 LogMAR, 6 patients reported a reduction in metamorphopsia, 5 patients a reduction in the intensity of the central scotoma. Mean retinal thickness significantly decreased from 324,54±15,16μm to 261,00±104,50μm; a reabsorption of subretinal fluid was reported in 11 patients, a reduction and disappearance of intraretinal edema and cysts was evident in 13 patients. Pigment epithelium detachment elevation was reduced in 5 of 10 patients. A significant reduction of angiographic activity was perceivable in 12 of 15 lesion studied.
Alfibercept appeared to be effective in modifying the natural history of ranibizumab non responders lesions. After a loading phase, morphological features improved because of reduction of exudative activity; visual acuity remained stable. OCT exam appeared to be the better way to follow the lesion activity and its modifications.