title: Early initial clinical experience with intravitreal aflibercept for wet age-related macular degeneration.
abstract: BACKGROUND
  Age-related macular degeneration (AMD) is a degenerative process that leads to severe vision loss. Wet AMD is defined by choroidal neovascularisation, leading to the accumulation of subretinal fluid (SRF), macular oedema (ME), and pigment epithelium detachments (PED). Purpose To evaluate the initial clinical experience of conversion from bevacizumab or ranibizumab to aflibercept in wet AMD patients.
  
  
  METHODS
  Records of 250 consecutive wet AMD patients were retrospectively reviewed. Of 250 patients, 29 were naive (with no previous treatment), and 221 were previously treated with bevacizumab (1/3) or ranibizumab (2/3). On average, converted patients received 14 injections every 6 weeks on a treat-and-extend regimen with Avastin or Lucentis before being converted to aflibercept every 7 weeks on average (no loading dose) for three doses. For the purposes of this study, we concentrated on the patients converted to aflibercept since the number of naive patients was too small to draw any conclusion from. Snellen (as logMar) visual acuities, and optical coherence tomography (OCT) were compared predrug and postdrug conversion.
  
  
  RESULTS
  Converted patients did not show a significant difference in visual acuity or average OCT thickness from preconversion values; however, small improvements in ME (p=0.0001), SRF (p=0.0001), and PED (p=0.008) grading were noted on average after conversion to aflibercept.
  
  
  CONCLUSIONS
  No significant difference in visual outcome or average OCT thickness was observed when switched from bevacizumab or ranibizumab q6 week to aflibercept 7-week dosing, on average. Mild anatomic improvements did occur in converted patients with regard to ME, SRF and PED improvement, on average, after conversion to aflibercept, and aflibercept was injected less frequently. No serious adverse reactions, including ocular infections or inflammation, as well as ocular and systemic effects were noted.
authors.affiliation: Island Vitreoretinal Consultants, Great Neck, New York, USA Columbia University New York, NY, USA.
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Ferrone
authors.affiliation: Department of Ophthalmology, North Shore-Long Island Jewish, Great Neck, New York, USA.
authors.forename: Farihah
authors.initials: F
authors.lastname: Anwar
authors.affiliation: Department of Ophthalmology, North Shore-Long Island Jewish, Great Neck, New York, USA.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Naysan
authors.affiliation: Department of Ophthalmology, North Shore-Long Island Jewish, Great Neck, New York, USA.
authors.forename: Khurram
authors.initials: K
authors.lastname: Chaudhary
authors.affiliation: Island Vitreoretinal Consultants, Great Neck, New York, USA.
authors.forename: David
authors.initials: D
authors.lastname: Fastenberg
authors.affiliation: Island Vitreoretinal Consultants, Great Neck, New York, USA.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Graham
authors.affiliation: Island Vitreoretinal Consultants, Great Neck, New York, USA.
authors.forename: Vincent
authors.initials: V
authors.lastname: Deramo
mesh_terms: D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D005654:Fundus Oculi; D006801:Humans; D058449:Intravitreal Injections; D008266:Macula Lutea / Q000473:pathology*; D008297:Male; D040262:Receptors, Vascular Endothelial Growth Factor / Q000008:administration & dosage* / Q000037:antagonists & inhibitors; D011993:Recombinant Fusion Proteins / Q000008:administration & dosage*; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D057135:Wet Macular Degeneration / Q000188:drug therapy* / Q000473:pathology
chemical_list: D020533:Angiogenesis Inhibitors; D011993:Recombinant Fusion Proteins; C533178:aflibercept; D040262:Receptors, Vascular Endothelial Growth Factor
keywords: Macula; Pharmacology; Retina; Treatment Medical