title: Intravitreal aflibercept in neovascular age-related macular degeneration previously treated with ranibizumab.
abstract: OBJECTIVE
  To report the change in visual acuity and central macular thickness (CMT) following treatment with intravitreal aflibercept injections in patients with neovascular age-related macular degeneration (nAMD) with suboptimum response to ranibizumab.
  
  
  METHODS
  This was a retrospective study. The inclusion criteria were patients with nAMD who responded poorly to ranibizumab. Patients then received either 3 consecutive aflibercept injections followed bypro re nata(PRN) treatment or PRN alone. Primary endpoints were mean change in best-corrected visual acuity (BCVA) and CMT at 12mo. Secondary endpoints were number of injections and adverse events.
  
  
  RESULTS
  Forty-nine eyes from 49 patients met the inclusion criteria and completed 12-month follow up on aflibercept. Thirty-eight eyes received 3 consecutive aflibercept injections followed by PRN treatment and 11 eyes received PRN injections alone. At 12mo, mean BCVA improved by one letters (logMAR 0.56±0.31 to 0.54±0.34) and mean CMT decreased from 303.9±82.1 to 259.2±108.3 µm. Four percent of eyes gained 15 letters or more, 6% lost more than 15 letters and the remaining 90% had stable BCVA. The mean number of aflibercept injections was 6. There was one case of infectious endophthalmitis.
  
  
  CONCLUSIONS
  Intravitreal aflibercept in patients with nAMD with a previous suboptimal response to ranibizumab resulted in an anatomical improvement in macular appearance at 12mo without a corresponding improvement in visual acuity.
authors.affiliation: Royal Devon and Exeter NHS Foundation Trust, Barrack Road, Exeter, EX2 5DW, United Kingdom.
authors.forename: Rachel Hui Fen
authors.initials: RH
authors.lastname: Lim
authors.affiliation: Royal Devon and Exeter NHS Foundation Trust, Barrack Road, Exeter, EX2 5DW, United Kingdom.
authors.forename: Bhaskar
authors.initials: B
authors.lastname: Gupta
authors.affiliation: Royal Devon and Exeter NHS Foundation Trust, Barrack Road, Exeter, EX2 5DW, United Kingdom.
authors.forename: Peter
authors.initials: P
authors.lastname: Simcock
keywords: aflibercept; neovascular age-related macular degeneration; ranibizumab