title: Efficacy of aflibercept on exudative age-related macular degeneration in patients exhibiting complete ranibizumab resistance and tachyphylaxis.
abstract: The present study compared the efficacy of aflibercept for neovascular age-related macular degeneration (NV-AMD) in patients with complete ranibizumab resistance and tachyphylaxis.
  Forty-four eyes of 38 neovascular age-related macular degeneration patients were evaluated. Eyes were divided into a complete resistance group (n=23 eyes) and tachyphylaxis group (n=21 eyes).
  After three injections, eight (38.1%) patients in the tachyphylaxis group and nine (39.1%) in the complete resistance group presented with macular dryness. After the first injection of aflibercept, the mean visual acuity improved significantly in the tachyphylaxis group (p=0.018) but remained unchanged in the complete resistance group (p=0.37). There was a non-significant trend towards improved mean visual acuity in both groups after the second and third injections relative to the acuity at the final visit for ranibizumab treatment. In the tachyphylaxis group, the presence of subfoveal pigmented epithelium detachment (PED) decreased significantly after intravitreal aflibercept treatment.
  Although treatment with aflibercept yielded generally positive anatomical results in both groups, no significant increase in visual acuity was achieved.
authors.affiliation: Department of Ophthalmology, Kayseri Military Hospital, Kayseri, Turkey.
authors.forename: Gokcen
authors.initials: G
authors.lastname: Gokce
authors.affiliation: Department of Ophthalmology, Gulhane Military Medical Academy, Ankara, Turkey.
authors.forename: Ali Hakan
authors.initials: AH
authors.lastname: Durukan
authors.affiliation: Department of Ophthalmology, Tatvan Military Hospital, Bitlis, Turkey.
authors.forename: Mehmet Talay
authors.initials: MT
authors.lastname: Koylu
authors.affiliation: Department of Ophthalmology, Gulhane Military Medical Academy, Ankara, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Kucukevcilioglu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D004351:Drug Resistance; D006801:Humans; D058449:Intravitreal Injections; D008268:Macular Degeneration / Q000150:complications / Q000188:drug therapy*; D008875:Middle Aged; D000069579:Ranibizumab / Q000627:therapeutic use*; D040262:Receptors, Vascular Endothelial Growth Factor / Q000008:administration & dosage / Q000627:therapeutic use*; D011993:Recombinant Fusion Proteins / Q000008:administration & dosage / Q000627:therapeutic use*; D012163:Retinal Detachment / Q000188:drug therapy / Q000209:etiology; D055213:Retinal Pigment Epithelium / Q000187:drug effects; D058471:Subretinal Fluid / Q000378:metabolism; D013618:Tachyphylaxis; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014792:Visual Acuity / Q000187:drug effects*
chemical_list: D020533:Angiogenesis Inhibitors; D011993:Recombinant Fusion Proteins; C533178:aflibercept; D040262:Receptors, Vascular Endothelial Growth Factor; D000069579:Ranibizumab