title: Clinical experience of switching anti-VEGF therapy from ranibizumab to aflibercept in age-related choroidal neovascularization.
abstract: OBJECTIVE
  To report the response of participants switching from ranibizumab to aflibercept treatment for neovascular age-related macular degeneration (nAMD) requiring further anti-vascular endothelial growth factor treatment.
  
  
  METHODS
  In this retrospective case review of 68 participants treated in a single hospital, all participants, prior to switching, received ranibizumab injections only. Best-corrected visual acuity (BCVA), clinical examination, and optical coherence tomography (OCT) were performed at each visit. Active nAMD was defined as persistent intraretinal or subretinal fluid on OCT. Participants had their first aflibercept injection at baseline and 2 more injections at 2 monthly intervals. Afterwards, they were followed up every 6-8 weeks and given injections as needed. The main outcome measures were visual acuity and the OCT central retinal thickness (CRT), average thickness (AT), and total macular volume (TMV).
  
  
  RESULTS
  The BCVA at baseline visit was 0.57 ± 0.33 log MAR and the final BCVA was 0.54 ± 0.37 log MAR (p = 0.215). The CRT mean change was -75.6 ± 85.6 (p = 0.001), the AT mean change was -24.2 ± 27.2 (p = 0.001), and TMV mean change was -0.69 ± 0.78 (p = 0.001). There were no significant ophthalmic complications related to treatments.
  
  
  CONCLUSIONS
  Intravitreal aflibercept improved anatomic outcomes (as measured by OCT) in eyes with nAMD that were previously treated with intravitreal ranibizumab and were still active. There was no statistically significant difference in logMAR visual acuity in participants who switched to aflibercept with a follow-up of at least 6 months.
authors.affiliation: Moorfields Eye Hospital NHS Trust, Croydon University Hospital, Surrey - UK.
authors.forename: Lauren
authors.initials: L
authors.lastname: Van Lancker
authors.affiliation: Moorfields Eye Hospital NHS Trust, Croydon University Hospital, Surrey - UK.
authors.forename: Robert
authors.initials: R
authors.lastname: Petrarca
authors.affiliation: Moorfields Eye Hospital NHS Trust, Croydon University Hospital, Surrey - UK.
authors.forename: Kyros
authors.initials: K
authors.lastname: Moutsouris
authors.affiliation: Moorfields Eye Hospital NHS Trust, Croydon University Hospital, Surrey - UK.
authors.forename: Panos
authors.initials: P
authors.lastname: Masaoutis
authors.affiliation: Moorfields Eye Hospital NHS Trust, Croydon University Hospital, Surrey - UK.
authors.forename: George
authors.initials: G
authors.lastname: Kampougeris
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage; D020256:Choroidal Neovascularization / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D005451:Fluorescein Angiography; D005654:Fundus Oculi; D006801:Humans; D058449:Intravitreal Injections; D008268:Macular Degeneration / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D000069579:Ranibizumab / Q000008:administration & dosage*; D040262:Receptors, Vascular Endothelial Growth Factor / Q000008:administration & dosage*; D011993:Recombinant Fusion Proteins / Q000008:administration & dosage*; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors*; D014792:Visual Acuity
chemical_list: D020533:Angiogenesis Inhibitors; D011993:Recombinant Fusion Proteins; D042461:Vascular Endothelial Growth Factor A; C533178:aflibercept; D040262:Receptors, Vascular Endothelial Growth Factor; D000069579:Ranibizumab