title: INTRAVITREAL AFLIBERCEPT FOR CHOROIDAL NEOVASCULARIZATION DUE TO AGE-RELATED MACULAR DEGENERATION UNRESPONSIVE TO RANIBIZUMAB THERAPY.
abstract: OBJECTIVE
  To assess the efficacy of intravitreal injection of aflibercept for treating choroidal neovascularization due to age-related macular degeneration unresponsive to ranibizumab.
  
  
  METHODS
  Prospective noncomparative study. Indication for conversion to aflibercept (2.0 mg) was a failed response to ranibizumab, defined as persistent or recurrent subretinal and/or intraretinal fluid on spectral domain optical coherence tomography. Best-corrected visual acuity (Early Treatment Diabetic Retinopathy Study letter score), fluorescein angiography, indocyanine green angiography, and spectral domain optical coherence tomography were performed at baseline. Patients were followed up monthly, and retreatment was considered at physician discretion based on functional and morphological patterns.
  
  
  RESULTS
  Ninety-two eyes were included in the study. At 12 months, mean best-corrected visual acuity (±SD) change was +1.8 (±10.3), Early Treatment Diabetic Retinopathy Study letters and central retinal thickness (±SD) decreased on average by 112 (±173) μm. Patients received a mean of 3.5 ± 1.8 injections. No significant adverse event was observed during the follow-up.
  
  
  CONCLUSIONS
  A low number of intravitreal aflibercept injections reversed the preswitching trend toward losing vision and produced stable visual acuity and morphological improvements for up to 12 months in patients with neovascular age-related macular degeneration, not responding to ranibizumab.
authors.affiliation: *Department of Medical and Biological Sciences-Ophthalmology, University of Udine, Udine, Italy; †Department of Ophthalmology, Fondazione G.B. Bietti-IRCCS, Rome, Italy; ‡Istituto Europeo di Microchirugia Oculare (IEMO), Udine, Italy; and §Department of Ophthalmology, University of Barcelona. Bellvitge University Hospital, Barcelona, Spain.
authors.forename: Valentina
authors.initials: V
authors.lastname: Sarao
authors.forename: Mariacristina
authors.initials: M
authors.lastname: Parravano
authors.forename: Daniele
authors.initials: D
authors.lastname: Veritti
authors.forename: Luis
authors.initials: L
authors.lastname: Arias
authors.forename: Monica
authors.initials: M
authors.lastname: Varano
authors.forename: Paolo
authors.initials: P
authors.lastname: Lanzetta
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D020256:Choroidal Neovascularization / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D057915:Drug Substitution; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D011446:Prospective Studies; D000069579:Ranibizumab / Q000627:therapeutic use*; D040262:Receptors, Vascular Endothelial Growth Factor / Q000627:therapeutic use*; D011993:Recombinant Fusion Proteins / Q000627:therapeutic use*; D058471:Subretinal Fluid; D041623:Tomography, Optical Coherence; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity / Q000502:physiology; D057135:Wet Macular Degeneration / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology
chemical_list: D020533:Angiogenesis Inhibitors; D011993:Recombinant Fusion Proteins; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; C533178:aflibercept; D040262:Receptors, Vascular Endothelial Growth Factor; D000069579:Ranibizumab