Treat-and-extend approach with aflibercept: Effects on different subtypes of age-related choroidal neovascularisation.
OBJECTIVE
To describe functional/morphological outcomes of treat-and-extend (TAE) with aflibercept in different subtypes of neovascularizations (CNV) secondary to exudative age-related macular degeneration (AMD).


METHODS
Retrospective study was conducted on 30 eyes of 30 patients treated with 2 mg-aflibercept according to a TAE protocol. Examinations included best corrected visual acuity (BCVA), number of injections, and visits needed. A quantitative/qualitative analysis was also performed with fluorescein angiography and spectral-domain optical coherence tomography (SD-OCT) at baseline, and at 3, 6, and 12 months.


RESULTS
BCVA significantly improved from 0.61±0.26 logMAR to 0.38±0.34 logMAR. Among the total AMD patients, type 1 CNV was diagnosed in 11 eyes (36%), type 2 CNV in 7 eyes (23%), mixed CNV in 5 eyes (16%), and type 3 CNV or retinal angiomatous proliferation (RAP) in 7 eyes (23%). The final mean number of injections was 7.5±1.65, 8.71±0.76, 7.4±0.89, 7.2±0.7, and number of visits 6.6±2.17, 7.89±1.46, 5.8±1.7, and 7.14±1.57, respectively in type 1, type 2, mixed, and type 3 or RAP. There was no difference between the different subtypes of CNV (P>.05).


CONCLUSIONS
Aflibercept in TAE is effective for all exudative-AMD subtypes. No significant differences in patient's visual gain, mean number of injections, or number of visits needed were found among the subtypes of CNV.
Servicio de Oftalmología, Hospital General Universitario de Valencia, Valencia. España; Escuela de Doctorado, Universidad Católica de Valencia San Vicente Mártir, Valencia, España. Electronic address: veronicacastronavarro@gmail.com.
V
V
Castro-Navarro
Servicio de Oftalmología, Hospital General Universitario de Valencia, Valencia. España.
E
E
Cervera-Taulet
Servicio de Oftalmología, Hospital General Universitario de Valencia, Valencia. España.
J
J
Montero-Hernández
Servicio de Oftalmología, Hospital General Universitario de Valencia, Valencia. España.
C
C
Navarro-Palop
D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D020256:Choroidal Neovascularization / Q000145:classification / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D040262:Receptors, Vascular Endothelial Growth Factor / Q000008:administration & dosage / Q000627:therapeutic use*; D011993:Recombinant Fusion Proteins / Q000008:administration & dosage / Q000627:therapeutic use*; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014792:Visual Acuity; D057135:Wet Macular Degeneration / Q000150:complications*
D020533:Angiogenesis Inhibitors; D011993:Recombinant Fusion Proteins; C533178:aflibercept; D040262:Receptors, Vascular Endothelial Growth Factor
Aflibercept; Choroidal neovascularisation; Choroidal thickness; Grosor coroideo; Neovascularización coroidea; Proliferación angiomatosa retiniana; Retinal angiomatous proliferation; Spectral-domain optical coherence tomography; Tomografía de coherencia óptica de dominio espectral; Tratar y extender; Treat and extend