Effect of aflibercept in insufficient responders to prior anti-VEGF therapy in neovascular AMDReport as inadecuate




Effect of aflibercept in insufficient responders to prior anti-VEGF therapy in neovascular AMD - Download this document for free, or read online. Document in PDF available to download.

Graefe-s Archive for Clinical and Experimental Ophthalmology

, Volume 252, Issue 11, pp 1705–1709

First Online: 11 March 2014Received: 08 January 2014Revised: 31 January 2014Accepted: 04 February 2014

Abstract

PurposeEvaluation of three aflibercept injections at 4-week intervals in patients with neovascular AMD showing an -insufficient anatomic response- to prior anti-VEGF therapy with ranibizumab or bevacizumab.

MethodsThe retrospective analysis included 96 eyes that had received at least three intravitreal 0.5 mg ranibizumab or 1.25 mg bevacizumab injections over a period of no more than 4 months prior to switching to aflibercept. In addition, the selected eyes had to have evidence of persisting or increasing sub- or intraretinal fluid, observed in optical coherence tomography OCT. All patients received a loading dose of three intravitreal 2 mg aflibercept injections at 4-week intervals. Evaluation included central retinal thickness CRT and maximum pigment epithelium PED height measured by spectral domain OCT and best-corrected visual acuity BCVA prior to the switch of therapy and 4 weeks after the third aflibercept injection.

ResultsA significant reduction of mean CRT −39 μm; p < 0.001 and maximum PED height −46 μm; p < 0.001 as found 4 weeks after the third aflibercept injection. Eighty-two out of 96 eyes 85 % had a PED just prior to switching to aflibercept. There was an improvement in BCVA of 1.9 letters 4 weeks after the last aflibercept injection; the vision gain, however, did not reach statistical significance p = 0.061. The further analysis did not show any correlation of the change in CRT, maximum PED, and BCVA with the number of prior anti-VEGF treatments.

ConclusionRetinal edema and PEDs regressed significantly after switching to aflibercept in patients insufficiently responding to prior therapy with ranibizumab or bevacizumab. No correlation could be found with regard to the number of prior treatments.

KeywordsAge-related macular degeneration Aflibercept Ranibizumab Bevacizumab Tolerance Tachyphylaxis  Download fulltext PDF



Author: Heidi Fassnacht-Riederle - Matthias Becker - Nicole Graf - Stephan Michels

Source: https://link.springer.com/







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