title: One-year real-world outcomes in patients receiving fixed-dosing aflibercept for neovascular age-related macular degeneration.
abstract: PurposeTo investigate 1-year visual and anatomic outcomes of intravitreal aflibercept for neovascular age-related macular degeneration (nAMD) given at a fixed 8-weekly interval.MethodsRetrospective, single-practice data analysis from an electronic medical record system of 255 eyes (223 patients) with treatment-naïve nAMD receiving 8-weekly aflibercept.ResultsMean logarithm of the minimum angle of resolution best-corrected visual acuity (BCVA) improved from 0.66 at baseline to 0.50 at month 11 (P<0.0001). Mean central retinal thickness (CRT) decreased from 311 μm at baseline to 211 μm at month 11 (P<0.0001). Our mean VA gain of eight ETDRS letters was comparable to the VIEW 1 and VIEW 2 Trials' results at the end of year 1. After loading at month 5, mean BCVA was 0.48 (P<0.0001), and mean CRT was 235 μm. At month 5, 143 eyes (56%) were inactive defined by the absence of macular haemorrhage and intraretinal fluid (IRF) and subretinal fluid (SRF) on optical coherence tomography, and 112 eyes (44%) remained active. At month 11, 136 eyes (53%) were inactive, and 119 eyes (47%) remained active. At month 11, 77% of inactive eyes after loading remained inactive, and 77% of the active eyes after loading remained active. At month 11, mean BCVA of the inactive group was 0.51, and mean BCVA of the active group was 0.48 (P=0.54).ConclusionsAflibercept administered by fixed dosing over 1 year improved VA and macular morphology in treatment-naïve eyes. Active lesions at month 11 do not have worse VA outcomes compared with inactive lesions. The macular status after loading is a reliable indicator of disease activity at the end of year 1.
authors.affiliation: Eye Unit, University Hospital Southampton NHS Foundation Trust, Southampton, Hampshire, UK.|Clinical and Experimental Sciences, University of Southampton, Southampton, Hampshire, UK.
authors.forename: H
authors.initials: H
authors.lastname: Almuhtaseb
authors.affiliation: Eye Unit, University Hospital Southampton NHS Foundation Trust, Southampton, Hampshire, UK.
authors.forename: S
authors.identifier: http://orcid.org/0000-0001-8973-7786
authors.initials: S
authors.lastname: Kanavati
authors.affiliation: Eye Unit, University Hospital Southampton NHS Foundation Trust, Southampton, Hampshire, UK.|Clinical and Experimental Sciences, University of Southampton, Southampton, Hampshire, UK.
authors.forename: S R
authors.initials: SR
authors.lastname: Rufai
authors.affiliation: Eye Unit, University Hospital Southampton NHS Foundation Trust, Southampton, Hampshire, UK.|Clinical and Experimental Sciences, University of Southampton, Southampton, Hampshire, UK.
authors.forename: A J
authors.identifier: http://orcid.org/0000-0001-5541-4305
authors.initials: AJ
authors.lastname: Lotery
mesh_terms: D000369:Aged, 80 and over; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D005654:Fundus Oculi; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D040262:Receptors, Vascular Endothelial Growth Factor / Q000008:administration & dosage* / Q000037:antagonists & inhibitors; D011993:Recombinant Fusion Proteins / Q000008:administration & dosage*; D012160:Retina / Q000473:pathology*; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014792:Visual Acuity; D057135:Wet Macular Degeneration / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology
chemical_list: D011993:Recombinant Fusion Proteins; C533178:aflibercept; D040262:Receptors, Vascular Endothelial Growth Factor