A New Anti-VEGF Inhibitor, Aflibercept: Treatment Outcomes Of Neovascular Macular Degeneration Refractory To Other Anti-VEGF Agents

Abstract

Purpose: To evaluate the treatment outcomes of aflibercept in patients with exudative age-related macular degeneration (AMD) resistant to other anti-vascular endothelial growth factor (VEGF) medications (bevacizumab, ranibizumab, and combination with or without dexamethasone and laser photocoagulation). Materials and Methods: A retrospective chart review of 56 patients (112 eyes) of persistent and recurrent exudative AMD treated prior with bevacizumab, ranibizumab, bevacizumab+dexamethasone intravitreal injections with or without combination of laser treatment was performed. Data analysis included demographics and treatment modalities to evaluate the visual acuity (VA) outcome, stabilization of AMD (central foveal thickness, CFT) and drug side effects (elevated intraocular pressure, IOP). Results: The mean age of the patients was 77 (range: 55-89) years. The mean central foveal thickness on optical coherence tomography (OCT) was 294 m (range: 80-585). Intravitreal aflibercept injections were given in both eyes in 10 patients and in 1 eye in 46 patients. The mean interval between aflibercept injections to the last follow-up (FU) visit was 1.7months (range: 0-7). F There was no statistically significant difference in visual acuity (p=0.6) after aflibercept injection, however VA was stable (median 20/60). The central foveal thickness had decreased significantly (p=0.005). Complete response to treatment was noted in 21 patients (41%). AMD was stable in 26 (50%) and persistent with no response in five patients (9%). Conclusions: Monthly intravitreal Aflibercept injections stabilized the exudative AMD in approximately half of the patients who had prior resistance to other anti-VEGF medications.