J Retin.  2021 Nov;6(2):99-109. 10.21561/jor.2021.6.2.99.

Clinical Outcomes of Aflibercept Treatment for Treatment-naive Exudative Age-related Macular Degeneration

• Choi YJ
• Choi YJ
• Cho YW
• Yoo WS
• Chung IY

• KMID: 2552175
• DOI: http://doi.org/10.21561/jor.2021.6.2.99

Abstract

Purpose
To evaluate the 1-year outcomes of the treat-and-extend regimen using intravitreal injection of aflibercept for treatment-naive exudative age-related macular degeneration (AMD) and the clinical results of switching to ranibizumab within the same period.
Methods
The change in best-corrected visual acuity (BCVA), central macular thickness (CMT) and number of injections was evaluated in 36 eyes first diagnosed with exudative AMD and treated with the treat-and-extend regimen using intravitreal injection of aflibercept, as well as 16 eyes switched from aflibercept to ranibizumab for improved efficacy within the same period.
Results
Mean BCVA improved significantly from 0.57 ± 0.28 logarithm of the minimum angle of resolution (logMAR) to 0.39 ± 0.29 logMAR at 12 months (p = 0.015) and mean CMT decreased significantly from 406.34 ± 69.18 μm to 269.58 ± 83.15 μm at 12 months in the 36 eyes on the treat-and-extend regimen of aflibercept (p = 0.004). The average number of injections per year was 6.8 ± 0.5. Of the 16 eyes that underwent a change in medication, seven eyes (63.6%) exhibited improvement or maintenance of initial visual acuity; mean CMT decreased significantly from 415.27 ± 73.63 μm prior to drug switch to 289.63 ± 62.78 μm after drug switch in the 11 eyes that received three injections of ranibizumab (p = 0.009).
Conclusions
A treat-and-extend regimen of intravitreal aflibercept injection was effective for exudative AMD in a clinical setting. Switching to ranibizumab for improved efficacy led to anatomical improvement and could help stabilize vision.

Keyword

Aflibercept; Age-related macular degeneration; Treat-and-extend regimen