Abstract
BackgroundTo study the clinical outcomes of pigment epithelial detachment (PED) associated with neovascular age-related macular degeneration (nAMD) in patients switched from Ranibizumab to Aflibercept.MethodsRetrospective non-comparative case series. 50 eyes with active nAMD and fovea involving PED of ≥100 μm measured manually using the caliper on the OCT, initially treated with intravitreal Ranibizumab (0.5 mg/0.05 ml) and later switched to Aflibercept (2.0 mg/0.05 ml). The outcome measures of best corrected visual acuity (BCVA), PED height, PED width and number of injections were measured at baseline and at time point of switch, 4 months, 1 year and at last follow up visit post-switch. Three paired t-tests and Pearson’s correlations were calculated to analyze variables at switch and change in variables at 1 year.ResultsAfter switch to Aflibercept, the improvement of BCVA was 1.84 (p = 0.11), 1.74 (p = 0.21) and 1.16 (p = 0.45) letters, the change in PED height was − 65.6μm (p < 0.001), − 50.64μm (p = 0.007) and − 68.48μm (p < 0.001) and the change in PED width was − 36.6μm (p = 0.514), + 29.7μm (p = 0.922) and + 118.4μm (p = 0.210) at 4 months, 1 year and the last visit respectively. There was a moderate negative correlation between reduction in PED height at 1 year after switch and PED height at the time of switch to Aflibercept (r = − 0.474, p < 0.05).ConclusionThe improvement in BCVA and change in PED width was not statistically significant however the reduction in PED height was significant after switching treatment to Aflibercept. The change in BCVA at 1 year after switch was not correlated with any of the analyzed anatomical characteristics of PED.
Highlights
To study the clinical outcomes of pigment epithelial detachment (PED) associated with neovascular age-related macular degeneration in patients switched from Ranibizumab to Aflibercept
The purpose of this study is to evaluate the clinical response in patients with PED associated with neovascular age-related macular degeneration (nAMD) whose treatment was switched from Ranibizumab to Aflibercept
We identified 218 eyes that were switched from Ranibizumab to Aflibercept for the treatment of nAMD during the period July 2013 to November 2015
Summary
To study the clinical outcomes of pigment epithelial detachment (PED) associated with neovascular age-related macular degeneration (nAMD) in patients switched from Ranibizumab to Aflibercept. Aflibercept has been shown to have pharmacological advantage of higher binding affinity to VEGF-A and a longer ligand binding activity [9]. This theoretical advantage and later introduction of Aflibercept have led to several studies investigating the switching from ranibizumab and/or bevacizumab to aflibercept in cases of refractory or rapidly recurring fluid in nAMD.
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