Response to aflibercept in patients with persistent exudation despite prior treatment with bevacizumab or ranibizumab for age-related macular degeneration.

Barbara Blodi // Justin Gottlieb // Michael Altaweel // Michael Ip // Michael Nork // Publications // Ronald Danis // Suresh Chandra // Sep 01 2014

PubMed ID: 25230402

Author(s): Eadie JA, Gottlieb JL, Ip MS, Blodi BA, Danis RP, Chandra SR, Nork TM, Altaweel MM, Stern-Hogan BS. Response to aflibercept in patients with persistent exudation despite prior treatment with bevacizumab or ranibizumab for age-related macular degeneration. Ophthalmic Surg Lasers Imaging Retina. 2014 Sep-Oct;45(5):394-7. PMID 25230402

Journal: Ophthalmic Surgery, Lasers & Imaging Retina, Volume 45, Issue 5,

BACKGROUND AND OBJECTIVE This study examines the clinical response of patients transitioned to aflibercept, the newest anti-VEGF medication, due to persistent evidence of exudation on optical coherence tomography (OCT) despite regular treatment with bevacizumab and/or ranibizumab.

PATIENTS AND METHODS Aflibercept was administered to 111 patients considered for study inclusion. Eyes were included if they were transitioned to aflibercept for treatment of persistent exudation on OCT despite regular treatment with at least three injections of ranibizumab or bevacizumab. Retrospective data were collected from medical records.

RESULTS Complete resolution of exudation was seen in 34% of eyes at final follow-up. Clear improvement in exudation amount or severity without complete resolution was seen in 25%. No improvement was seen in 34%, and 6% demonstrated worsening of exudation. Snellen visual acuity at the time of transition versus final follow-up after aflibercept injection did not appreciably change (logMAR 0.494 to 0.505, Snellen equivalent 20/62 to 20/64; P = .84). The mean center point neurosensory retina thickness decreased from 228.6 to 176.9 ┬Ám (P = .001).

CONCLUSION Aflibercept may decrease the amount of exudation in a significant number of patients. However, this reduction did not result in an improvement in Snellen visual acuity.