title: Visual and anatomical outcomes of intravitreal aflibercept for treatment-resistant neovascular age-related macular degeneration.
abstract: A retrospective chart review of patients with persistent subretinal and/or intraretinal fluid, despite previous treatment with intravitreal ranibizumab (0.5 mg), who were switched to aflibercept injections, was performed. Treatment was three monthly aflibercept (2 mg) injections followed by dosing on pro re nata basis. Main outcome measures included changes in best corrected visual acuity (BCVA), 1 mm central subfield (CSF) retinal thickness, the height of the pigment epithelial detachment (PED), and subfoveal choroidal thickness on optical coherence tomography at 6 months. Thirty-one eyes of 30 patients were analyzed. The mean number of injections before aflibercept conversion was 34.4 ± 11.9. After an average of 4.5 aflibercept injections (range 3 to 6) over 6 months, no significant change in BCVA was observed (P > 0.05). Compared with baseline, there was a significant reduction of the CSF retinal thickness (449 ± 179 versus 269 ± 145  μ m, P < 0.001), maximum PED height (262 ± 134 versus 183 ± 100  μ m, P < 0.001), and choroidal thickness (192 ± 67 versus 167 ± 51  μ m, P < 0.01). Stable visual acuity and anatomical improvement were obtained for up to 6 months after aflibercept conversion. However, choroidal thinning related to treatment was observed.
authors.affiliation: Sapienza University of Rome, Policlinico Umberto I Hospital, 155 Viale del Policlinico, 00161 Rome, Italy.
authors.forename: Magda
authors.initials: M
authors.lastname: Gharbiya
authors.affiliation: Casa di Cura Privata Villa Benedetta, 65 Circonvallazione Cornelia, 00165 Rome, Italy.
authors.forename: Ludovico
authors.identifier: 0000-0002-1009-3613
authors.initials: L
authors.lastname: Iannetti
authors.affiliation: Sapienza University of Rome, Policlinico Umberto I Hospital, 155 Viale del Policlinico, 00161 Rome, Italy.
authors.forename: Francesco
authors.identifier: 0000-0002-2516-8331
authors.initials: F
authors.lastname: Parisi
authors.affiliation: Casa di Cura Privata Villa Margherita, 48 Viale di Villa Massimo, 00161 Rome, Italy.
authors.forename: Umberto
authors.identifier: 0000-0001-8557-3964
authors.initials: U
authors.lastname: De Vico
authors.affiliation: Casa di Cura Privata Villa Margherita, 48 Viale di Villa Massimo, 00161 Rome, Italy.
authors.forename: Maria Laura
authors.initials: ML
authors.lastname: Mungo
authors.affiliation: Casa di Cura Privata Villa Margherita, 48 Viale di Villa Massimo, 00161 Rome, Italy.
authors.forename: Marco
authors.identifier: 0000-0002-3755-4352
authors.initials: M
authors.lastname: Marenco
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage; D004351:Drug Resistance; D005260:Female; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D008875:Middle Aged; D000069579:Ranibizumab; D040262:Receptors, Vascular Endothelial Growth Factor / Q000008:administration & dosage*; D011993:Recombinant Fusion Proteins / Q000008:administration & dosage*; D012189:Retrospective Studies; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors*; D014786:Vision Disorders / Q000175:diagnosis* / Q000209:etiology / Q000517:prevention & control*; D014792:Visual Acuity / Q000187:drug effects*; D057135:Wet Macular Degeneration / Q000150:complications / Q000188:drug therapy* / Q000473:pathology*
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D011993:Recombinant Fusion Proteins; D042461:Vascular Endothelial Growth Factor A; C533178:aflibercept; D040262:Receptors, Vascular Endothelial Growth Factor; D000069579:Ranibizumab