title: INCIDENCE AND CAUSES OF VISION LOSS DURING AFLIBERCEPT TREATMENT FOR NEOVASCULAR AGE-RELATED MACULAR DEGENERATION: One-Year Follow-up.
abstract: OBJECTIVE
  To investigate the incidence rate, risk factors, and final outcomes of patients with age-related macular degeneration (AMD) who have experienced vision loss despite periodic aflibercept treatment.
  
  
  METHODS
  Subjects with treatment-naive AMD were prospectively recruited and treated with three monthly injections followed by two monthly injections of aflibercept. The incidence rate and risk factors of more than two lines of vision loss at any visit were investigated.
  
  
  RESULTS
  We included 196 eyes of 196 patients. Vision loss was observed in 16 patients (8.2%). Eleven of 16 patients developed vision loss during the initial 3 months (68.8%). Vision loss remained in 11 eyes (68.8%) at the final visit. The maximum pigment epithelium detachment (PED) height (odds ratio = 1.46 for a 100-μm increase in the PED height) and disruption of the external limiting membrane (odds ratio = 4.45) were identified as risk factors for developing vision loss on logistic regression analysis.
  
  
  CONCLUSIONS
  The incidence rate of vision loss during aflibercept treatment was relatively low. Identifying high-risk patients, those with a high PED height and disruption of the external limiting membrane, would be helpful in ensuring appropriate informed consent before treatment. Further studies are needed to establish optimal treatment for these patients.
authors: *Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan; and †Department of Ophthalmology, Kagawa University Faculty of Medicine, Miki, Japan.
authors: Masayuki
authors: M
authors: Hata
authors: Akio
authors: A
authors: Oishi
authors: Kenji
authors: K
authors: Yamashiro
authors: Sotaro
authors: S
authors: Ooto
authors: Hiroshi
authors: H
authors: Tamura
authors: Hideo
authors: H
authors: Nakanishi
authors: Naoko
authors: N
authors: Ueda-Arakawa
authors: Yumiko
authors: Y
authors: Akagi-Kurashige
authors: Yoshimasa
authors: Y
authors: Kuroda
authors: Ayako
authors: A
authors: Takahashi
authors: Akitaka
authors: A
authors: Tsujikawa
authors: Nagahisa
authors: N
authors: Yoshimura
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001766:Blindness / Q000139:chemically induced* / Q000453:epidemiology*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D058449:Intravitreal Injections; D007564:Japan / Q000453:epidemiology; D008297:Male; D011446:Prospective Studies; D040262:Receptors, Vascular Endothelial Growth Factor / Q000008:administration & dosage / Q000037:antagonists & inhibitors; D011993:Recombinant Fusion Proteins / Q000008:administration & dosage / Q000009:adverse effects*; D055213:Retinal Pigment Epithelium / Q000187:drug effects / Q000473:pathology; D012307:Risk Factors; D013997:Time Factors; D041623:Tomography, Optical Coherence; D014792:Visual Acuity; D057135:Wet Macular Degeneration / Q000175:diagnosis / Q000188:drug therapy*
chemical_list: D011993:Recombinant Fusion Proteins; C533178:aflibercept; D040262:Receptors, Vascular Endothelial Growth Factor