Cristina Calvo-Gonzalez1, Juan Reche-Frutos2, José Ignacio Fernández-Vigo2, Juan Donate-López2, Irene Serrano-García3, Cristina Fernández-Pérez3. 1. Department of Ophthalmology, Hospital Universitario Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), c/Profesor Martin Lagos, 28040, Madrid, Spain. calvo_glez@yahoo.es. 2. Department of Ophthalmology, Hospital Universitario Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), c/Profesor Martin Lagos, 28040, Madrid, Spain. 3. Department of Preventive Medicine, Hospital Universitario Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), Madrid, Spain.
Abstract
PURPOSE: To describe indocyanine green angiography (ICGA) and visual acuity (VA) results in patients with neovascular age-related macular degeneration (nAMD) refractory to ranibizumab switched to aflibercept. METHODS: This study is a prospective interventional case series. Thirty-two eyes of 32 patients with nAMD showing a poor response after at least 24 months of ranibizumab were switched to aflibercept. Twenty eyes had type I choroidal neovascularization (CNV group), and 12 eyes had polypoidal choroidal vasculopathy (PCV group). After an initial loading dose of three monthly aflibercept injections, treatment was continued on a treat-and-extend basis. ICGA was performed just before the first aflibercept injection (baseline) and 12 and 24 months later. The variables recorded were: closure of polyps and lesion area, VA, number of aflibercept injections, dry macula, and pigment epithelium detachment. RESULTS: The following means were recorded in the CNV and PCV groups, respectively: number of ranibizumab injections 20.4 ± 11.2 and 22.4 ± 12.9 (p = 0.740); baseline VA (before aflibercept) 73.2 ± 9.1 and 70.3 ± 13.7 letters (p = 0.654); and final VA 73.0 ± 7.6 and 69.3 ± 15.6 letters (p = 0.509). VA remained stable (p = 0.761 and 0.964) after 15.5 ± 3 and 15.1 ± 3.5 aflibercept injections (p = 0.244). At 24 months, dry macula was noted in 40 to 50% of the eyes (p = 0.620). Complete resolution of polyps was observed in 58% at 12 months and 92% at 24 months. CONCLUSIONS: In patients with nAMD refractory to ranibizumab, aflibercept was effective at maintaining VA and closing numerous polyps. In half of the patients, dry macula was observed at 24 months.
PURPOSE: To describe indocyanine green angiography (ICGA) and visual acuity (VA) results in patients with neovascular age-related macular degeneration (nAMD) refractory to ranibizumab switched to aflibercept. METHODS: This study is a prospective interventional case series. Thirty-two eyes of 32 patients with nAMD showing a poor response after at least 24 months of ranibizumab were switched to aflibercept. Twenty eyes had type I choroidal neovascularization (CNV group), and 12 eyes had polypoidal choroidal vasculopathy (PCV group). After an initial loading dose of three monthly aflibercept injections, treatment was continued on a treat-and-extend basis. ICGA was performed just before the first aflibercept injection (baseline) and 12 and 24 months later. The variables recorded were: closure of polyps and lesion area, VA, number of aflibercept injections, dry macula, and pigment epithelium detachment. RESULTS: The following means were recorded in the CNV and PCV groups, respectively: number of ranibizumab injections 20.4 ± 11.2 and 22.4 ± 12.9 (p = 0.740); baseline VA (before aflibercept) 73.2 ± 9.1 and 70.3 ± 13.7 letters (p = 0.654); and final VA 73.0 ± 7.6 and 69.3 ± 15.6 letters (p = 0.509). VA remained stable (p = 0.761 and 0.964) after 15.5 ± 3 and 15.1 ± 3.5 aflibercept injections (p = 0.244). At 24 months, dry macula was noted in 40 to 50% of the eyes (p = 0.620). Complete resolution of polyps was observed in 58% at 12 months and 92% at 24 months. CONCLUSIONS: In patients with nAMD refractory to ranibizumab, aflibercept was effective at maintaining VA and closing numerous polyps. In half of the patients, dry macula was observed at 24 months.
Authors: K Bailey Freund; Jean-François Korobelnik; Robert Devenyi; Carsten Framme; John Galic; Edward Herbert; Hans Hoerauf; Paolo Lanzetta; Stephan Michels; Paul Mitchell; Jordi Monés; Carl Regillo; Ramin Tadayoni; James Talks; Sebastian Wolf Journal: Retina Date: 2015-08 Impact factor: 4.256
Authors: Andrew A Chang; Haitao Li; Geoffrey K Broadhead; Thomas Hong; Timothy E Schlub; Wijeyanthy Wijeyakumar; Meidong Zhu Journal: Ophthalmology Date: 2013-10-18 Impact factor: 12.079
Authors: Marta Medina-Baena; María Jesús Huertos-Carrillo; Laura Rodríguez; Juan Ignacio García-Pulido; Carlos Cornejo-Castillo; José María Calandria-Amiguetti Journal: Case Rep Ophthalmol Date: 2018-03-02