title: Switch to a single dose of aflibercept in bevacizumab nonresponders with AMD.
abstract: OBJECTIVE
  This study aimed to report on the efficacy of 1 dose of aflibercept in bevacizumab nonresponders.
  
  
  METHODS
  This was a retrospective, single-centre, interventional, noncomparative study.
  
  
  METHODS
  This study retrospectively analyzed 23 patients with persistent intraretinal or subretinal fluid treated with 6 or more monthly bevacizumab injections.
  
  
  METHODS
  Patients were switched to 1 dose of aflibercept and afterward continued their therapy with bevacizumab for at least another 6 months. We performed spectral domain optical coherence tomography monthly and evaluated visual acuity, central retinal thickness, and photoreceptor defects. The main outcome measures were visual and anatomic outcome 1 and 6 months after administering aflibercept.
  
  
  RESULTS
  Visual acuity significantly improved (p = 0.01) after the switch to aflibercept (from 0.39 to 0.49 Snellen). This improvement was stable for the remaining 6 months of the study (final visual acuity, 0.46 Snellen); 47% of patients experienced an improvement of at least 5 letters from baseline on a chart of the ETDRS type (Early Treatment Diabetic Retinopathy Study). Central retinal thickness decreased from 521 µm to 446 µm (p = 0.01) and remained stable for the next 6 months (452 µm). Complete resolution of intraretinal and subretinal fluid was observed in 30% of eyes.
  
  
  CONCLUSIONS
  In bevacizumab nonresponders, switching to a single dose of aflibercept before continuing the therapy with bevacizumab improves visual outcome and anatomic results.
authors.affiliation: Ophthalmic Clinic Jasne Blonia, Rojna 90, Lodz, Poland; Third Municipal Hospital, K. Jonscher, Milionowa 14, Lodz, Poland.
authors.forename: Janusz
authors.initials: J
authors.lastname: Michalewski
authors.affiliation: Ophthalmic Clinic Jasne Blonia, Rojna 90, Lodz, Poland; Third Municipal Hospital, K. Jonscher, Milionowa 14, Lodz, Poland.
authors.forename: Jerzy
authors.initials: J
authors.lastname: Nawrocki
authors.affiliation: Third Municipal Hospital, K. Jonscher, Milionowa 14, Lodz, Poland.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Trębińska
authors.affiliation: Ophthalmic Clinic Jasne Blonia, Rojna 90, Lodz, Poland; Third Municipal Hospital, K. Jonscher, Milionowa 14, Lodz, Poland. Electronic address: zosia_n@yahoo.com.
authors.forename: Zofia
authors.initials: Z
authors.lastname: Michalewska
mesh_terms: D000368:Aged; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D000068258:Bevacizumab; D004351:Drug Resistance; D057915:Drug Substitution; D005260:Female; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D008875:Middle Aged; D040262:Receptors, Vascular Endothelial Growth Factor / Q000008:administration & dosage*; D011993:Recombinant Fusion Proteins / Q000008:administration & dosage*; D012160:Retina / Q000473:pathology; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000187:drug effects; D057135:Wet Macular Degeneration / Q000175:diagnosis / Q000188:drug therapy*
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D011993:Recombinant Fusion Proteins; C533178:aflibercept; D000068258:Bevacizumab; D040262:Receptors, Vascular Endothelial Growth Factor