title: Rapid response of retinal pigment epithelial detachments to intravitreal aflibercept in neovascular age-related macular degeneration refractory to bevacizumab and ranibizumab.
abstract: OBJECTIVE
  The aim of this study is to report the short-term efficacy of aflibercept in the treatment of neovascular age-related macular degeneration (AMD) with associated retinal pigment epithelial detachment (PED) which is refractory or develops tachyphylaxis to bevacizumab and ranibizumab.
  
  
  METHODS
  The method comprised a retrospective review of the medical records of patients with neovascular AMD and associated PEDs recently treated with aflibercept and previously treated with bevacizumab and ranibizumab.
  
  
  RESULTS
  Three eyes of three female patients of ages 49, 55, and 65 years old with large serous PEDs and subretinal fluid (SRF) associated with occult choroidal neovascularization and neovascular AMD were treated with aflibercept after intravitreal bevacizumab and/or ranibizumab failed to resolve the lesions. All had complete resolution of SRF and complete or near-complete resolution of the PEDs after aflibercept injections over a 3-month period. Visual acuity improved in all three eyes.
  
  
  CONCLUSIONS
  Intravitreal aflibercept may be an effective treatment option for serous PED in neovascular AMD patients after bevacizumab and ranibizumab have previously failed. Larger studies with longer follow-up are required to determine the role of aflibercept in treatment of PED in neovascular AMD.
authors.affiliation: Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, IL 60612, USA.
authors.forename: K H
authors.initials: KH
authors.lastname: Patel
authors.forename: C C
authors.initials: CC
authors.lastname: Chow
authors.forename: R
authors.initials: R
authors.lastname: Rathod
authors.forename: W F
authors.initials: WF
authors.lastname: Mieler
authors.forename: J I
authors.initials: JI
authors.lastname: Lim
authors.forename: L J
authors.initials: LJ
authors.lastname: Ulanski
authors.forename: Y I
authors.initials: YI
authors.lastname: Leiderman
authors.forename: V
authors.initials: V
authors.lastname: Arun
authors.forename: F Y
authors.initials: FY
authors.lastname: Chau
mesh_terms: D000368:Aged; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D000068258:Bevacizumab; D020256:Choroidal Neovascularization / Q000150:complications / Q000188:drug therapy*; D005260:Female; D006801:Humans; D058449:Intravitreal Injections; D008268:Macular Degeneration / Q000150:complications / Q000188:drug therapy*; D008875:Middle Aged; D000069579:Ranibizumab; D040262:Receptors, Vascular Endothelial Growth Factor / Q000008:administration & dosage*; D011993:Recombinant Fusion Proteins / Q000008:administration & dosage*; D012163:Retinal Detachment / Q000188:drug therapy* / Q000209:etiology; D012189:Retrospective Studies; D017211:Treatment Failure
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D011993:Recombinant Fusion Proteins; C533178:aflibercept; D000068258:Bevacizumab; D040262:Receptors, Vascular Endothelial Growth Factor; D000069579:Ranibizumab
references.citation: Br J Ophthalmol. 2012 Jan;96(1):21-3
references.pmid: 21733918
references.citation: Retina. 2009 Jun;29(6):723-31
references.pmid: 19516114
references.citation: Br J Ophthalmol. 2012 Jan;96(1):14-20
references.pmid: 21791509
references.citation: Am J Ophthalmol. 2009 Jul;148(1):70-8.e1
references.pmid: 19403115
references.citation: Arch Ophthalmol. 1991 Sep;109(9):1220-31
references.pmid: 1718250
references.citation: Semin Ophthalmol. 2011 May;26(3):198-208
references.pmid: 21609233
references.citation: Am J Ophthalmol. 2007 Oct;144(4):592-9
references.pmid: 17698019
references.citation: N Engl J Med. 2006 Oct 5;355(14):1419-31
references.pmid: 17021318
references.citation: Graefes Arch Clin Exp Ophthalmol. 2002 Jul;240(7):533-8
references.pmid: 12136282
references.citation: N Engl J Med. 2006 Oct 5;355(14):1432-44
references.pmid: 17021319
references.citation: Br J Ophthalmol. 2012 Jan;96(1):1-2
references.pmid: 22157632
references.citation: Expert Opin Pharmacother. 2012 Mar;13(4):585-91
references.pmid: 22300011
references.citation: Clin Ophthalmol. 2010 Apr 26;4:369-74
references.pmid: 20463807