title: Transitioning to intravitreal aflibercept following a previous treat-and-extend dosing regimen in neovascular age-related macular degeneration: 24-month results.
abstract: OBJECTIVE
  To evaluate frequency of injections, visual and anatomical outcomes of neovascular age-related macular degeneration (nAMD) patients transitioned to intravitreal aflibercept after failure to extend treatment interval beyond 8 weeks with prior intravitreal bevacizumab or ranibizumab.
  
  
  METHODS
  Retrospective review of patients with nAMD switched to aflibercept following ≥ 6 prior intravitreal ranibizumab or bevacizumab injections at 4-8-week intervals. Three monthly aflibercept injections were given followed by a treat-and-extend dosing regimen.
  
  
  RESULTS
  Twenty-one eyes of 18 patients who had received a mean of 23.8 ± 18.8 (mean ± SD; range 6-62) prior ranibizumab or bevacizumab injections were included. Over a mean follow-up of 24 months after the transition, 9.2 ± 2.9 (range 4-21) aflibercept injections were required. Interval between aflibercept injections increased to 57.3 days (range 35-133 days), as compared with 37 ± 6.1 days (range 29-54 days) with the prior agents (P = 0.01). Mean best-corrected visual acuity was preserved (0.42 ± 0.31 vs 0.42 ± 0.23 logMAR; P = 0.2). Mean OCT central subfoveal thickness (292.1 ± 83.2 μm to 283.6 ± 78.6 μm; P = 0.4) and mean macular volume (7.9 ± 0.95 mm(3) to 7.67 ± 0.94 mm(3); P = 0.16) remained stable.
  
  
  CONCLUSIONS
  Patients requiring treatment more frequently than every 8 weeks with ranibizumab and bevacizumab were transitioned to > 8-week treatment interval with aflibercept while maintaining the anatomic and visual gains.
authors.affiliation: Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: N
authors.initials: N
authors.lastname: Homer
authors.affiliation: Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.|Department of Ophthalmology, Duke University Eye Center, Durham, NC, USA.
authors.forename: D S
authors.initials: DS
authors.lastname: Grewal
authors.affiliation: Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: R G
authors.initials: RG
authors.lastname: Mirza
authors.affiliation: Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: A T
authors.initials: AT
authors.lastname: Lyon
authors.affiliation: Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: M K
authors.initials: MK
authors.lastname: Gill
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D000068258:Bevacizumab / Q000627:therapeutic use; D057915:Drug Substitution; D005260:Female; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000188:drug therapy*; D000069579:Ranibizumab / Q000627:therapeutic use; D040262:Receptors, Vascular Endothelial Growth Factor / Q000008:administration & dosage*; D011993:Recombinant Fusion Proteins / Q000008:administration & dosage*; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D014792:Visual Acuity; D057135:Wet Macular Degeneration / Q000188:drug therapy*
chemical_list: D020533:Angiogenesis Inhibitors; D011993:Recombinant Fusion Proteins; C533178:aflibercept; D000068258:Bevacizumab; D040262:Receptors, Vascular Endothelial Growth Factor; D000069579:Ranibizumab