title: [Evaluation of the efficacy of aflibercept's in the treatment of neovascular age-related macular degeneration in treatment-naive and switched patients. Report of 86 cases].
abstract: BACKGROUND
  AMD (age-related macular degeneration) is the leading cause of legal blindness after age 50 in developed countries. Anti-VEGF therapy by intravitreal injection has become the standard for the treatment of neovascular AMD. Ranibizumab is the most currently used, but the arrival of aflibercept on the market 1 year ago is changing clinical practices in France.
  
  
  METHODS
  The objective of this study is to evaluate the efficacy of aflibercept in AMD. All patients with neovascular AMD undergoing IVT (intra-vitreal injection) of aflibercept were included. All patients had at baseline and on follow-up visits a measurement of best corrected visual acuity (ETDRS), a fundus examination and an OCT. For statistical analysis, we analyzed the data at 0, 3, 6 and 12 months. An induction phase was carried out for treatment-naive patients, and follow-up was performed according to the PRN method (Pro Re Nata). The total number of injections over the entire follow-up period was recorded.
  
  
  RESULTS
  Ninety-six eyes were included, with 17 treatment-naive patients and 69 patients who had previously received ranibizumab. At 1 year, all patients had a mean improvement of 5.4 ETDRS letters (P=0.0026). The OCT data showed a rapid decline in retinal thickness, from baseline to the third month, of 143 microns on average (P=5.6×10(-15)); between the 3rd and 6th month, this was slower, with an average decrease of 4.6 microns, and between the 6th and the 12th month, the difference was significant, with an average decrease of 36 microns (P=0.003). The number of injections over one year was 5.7 on average.
  
  
  CONCLUSIONS
  The efficacy of aflibercept with a PRN protocol provides interesting results, with an improvement in visual acuity and central retinal thickness in all treated groups, and with fewer injections than advocated.
authors.affiliation: Service d'ophtalmologie, hôpital Charles-Nicolle, CHU de Rouen, 1, rue de Germont, 76031 Rouen, France. Electronic address: elodie.maringe@gmail.com.
authors.forename: E
authors.initials: E
authors.lastname: Maringe
authors.affiliation: Service d'ophtalmologie, hôpital Charles-Nicolle, CHU de Rouen, 1, rue de Germont, 76031 Rouen, France.
authors.forename: E
authors.initials: E
authors.lastname: Letesson
authors.affiliation: Service d'ophtalmologie, hôpital Charles-Nicolle, CHU de Rouen, 1, rue de Germont, 76031 Rouen, France.
authors.forename: A
authors.initials: A
authors.lastname: Duncombe
authors.affiliation: Service d'ophtalmologie, hôpital Charles-Nicolle, CHU de Rouen, 1, rue de Germont, 76031 Rouen, France.
authors.forename: M
authors.initials: M
authors.lastname: Muraine
authors.affiliation: Clinique Saint-Hilaire, 2, place Saint-Hilaire, 76000 Rouen, France.
authors.forename: O
authors.initials: O
authors.lastname: Genevois
mesh_terms: D057915:Drug Substitution; D005500:Follow-Up Studies; D005602:France; D006801:Humans; D058449:Intravitreal Injections; D008268:Macular Degeneration / Q000150:complications / Q000188:drug therapy*; D000069579:Ranibizumab / Q000008:administration & dosage; D040262:Receptors, Vascular Endothelial Growth Factor / Q000008:administration & dosage* / Q000627:therapeutic use; D011993:Recombinant Fusion Proteins / Q000008:administration & dosage* / Q000627:therapeutic use; D015861:Retinal Neovascularization / Q000150:complications / Q000188:drug therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity / Q000187:drug effects
chemical_list: D011993:Recombinant Fusion Proteins; C533178:aflibercept; D040262:Receptors, Vascular Endothelial Growth Factor; D000069579:Ranibizumab
keywords: AMD; Acuité visuelle; Aflibercept; Central macular thickness; DMLA; Ranibizumab; Visual acuity; Épaisseur maculaire centrale