Abstract
Results CRT and logMAR VA were 349.62 ± 223.51 μm and 0.50 ± 0.23 at the baseline and 274.69 ± 148.77 μm and 0.46 ± 0.24, 311.54 ± 192.90 μm and 0.45 ± 0.20 at 1 month after the first and third ranibizumab injections, respectively. The CRT decrease during three ranibizumab injections was statistically significant (38.08 ± 69.52 μm, p=0.033). Change in VA was not statistically significant. The percentage of eyes with SRF was 100% at baseline and 53.8%, 76.9%, and 69.2% one month after each ranibizumab injections. The percentage of eyes with IRF was 38.5% at baseline and 23.1%, 23.1%, and 15.4%, respectively, after switching. Conclusion Switching to monthly ranibizumab in nAMD showing an insufficient response to bimonthly aflibercept led to immediate anatomical improvement. It can be considered in countries where the healthcare insurance system limits the minimum injection interval of aflibercept.
Highlights
Age-related macular degeneration (AMD) is one of the significant causes of blindness worldwide. e gold standard treatment for neovascular age-related macular degeneration is an intravitreal antivascular endothelial growth factor (VEGF) therapy
In South Korea, where the solitary national health insurance system has limited the minimum interval of aflibercept treatment to two months, switching to monthly ranibizumab treatment or additional bevacizumab treatment might be required for these patients
We identified 13 eyes from 13 patients with neovascular AMD showing an insufficient treatment response to aflibercept treatment. ese patients showed remaining or increasing subretinal fluid (SRF) during three consecutive successive aflibercept intravitreal injections before switching and received three consecutive monthly ranibizumab intravitreal injections
Summary
Age-related macular degeneration (AMD) is one of the significant causes of blindness worldwide. e gold standard treatment for neovascular age-related macular degeneration (nAMD) is an intravitreal antivascular endothelial growth factor (VEGF) therapy. Or bimonthly intravitreal aflibercept injections demonstrated similar therapeutic effects as monthly intravitreal ranibizumab injections [5] Based on these reports, the health insurance system in many countries, including Korea, sets a minimum intravitreal injection interval of 2 months for aflibercept. E real-world data of treatment and extend (T&E) treatment for nAMD using aflibercept shows a subgroup of patients who need treatment at intervals shorter than two months [7]. In South Korea, where the solitary national health insurance system has limited the minimum interval of aflibercept treatment to two months, switching to monthly ranibizumab treatment or additional bevacizumab treatment might be required for these patients. Previous studies using real-world data confirmed that, in many countries, the minimum dosing interval of aflibercept is limited to 2 months. Is report evaluates the switching effect in terms of “anti-VEGF resistance” and the efficacy of monthly ranibizumab treatment in patients with nAMD showing an insufficient treatment response to bimonthly aflibercept; we investigated the anatomical and functional outcomes after switching from bimonthly aflibercept to monthly ranibizumab
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
