Abstract
BackgroundTo evaluate the three-year outcome after intravitreal aflibercept injection (IAI) for neovascular age-related macular degeneration (nAMD).MethodsForty-nine treatment-naïve nAMD patients (50 eyes) were enrolled in this prospective study. The eyes received IAI at two-month intervals in the first year. The treatment regimen was changed to IAI based on a treat-and-extend approach in the second and third years.ResultsTwenty-nine eyes of 28 patients were successfully followed up over 36 months. The nAMD subtypes included 15 eyes with typical AMD and 14 eyes with polypoidal choroidal vasculopathy. The number of IAIs performed over the 3 years was 17.2 ± 3.1 (mean ± standard deviation). The mean logMAR, which was 0.42 at baseline, improved to 0.19 (P = 0.001) at 12 months, and 0.26 (P = 0.049) at 36 months. The central retinal thickness (CRT) was 329 ± 120 μm at baseline, 151 ± 38 μm (P < 0.001) at 12 months, and 143 ± 61 μm (P < 0.001) at 36 months. The mean subfoveal choroidal thickness (SFCT) was 288 ± 97 μm at baseline, 243 ± 82 μm (P < 0.001) at 12 months, and 208 ± 63 μm (P < 0.01) at 36 months. The changes in logMAR, CRT, and SFCT over the study period did not differ between typical AMD and PCV.ConclusionLong-term aflibercept injection can achieve visual improvement and reduce the thickness of the retina and choroid in nAMD. Morphological improvement of these tissues may not be sufficient to sustain earlier visual improvement over the long-term.
Highlights
To evaluate the three-year outcome after intravitreal aflibercept injection (IAI) for neovascular agerelated macular degeneration
Ophthalmic examinations We evaluated visual acuity, which was calculated from decimal visual acuity, central retinal thickness (CRT), subfoveal choroidal thickness (SFCT), and the number of IAIs
Twenty-one patients (43%) were unable to be followed-up for the full 36 months; six patients changed hospital, four patients had cataract surgery, five patients discontinued their visits for unknown reasons, and six patients were excluded from the analysis due to irregular treatment intervals
Summary
To evaluate the three-year outcome after intravitreal aflibercept injection (IAI) for neovascular agerelated macular degeneration (nAMD). Age-related macular degeneration (AMD), classified as atrophic or neovascular, is a leading cause of blindness in developed countries [1]. Various treatment modalities, such as laser therapy [2], photodynamic therapy [3], and radiotherapy [4], have been developed for AMD. Aflibercept has been reported to provide favorable results for subretinal lesions, such as retinal pigment epithelium detachment [5] These results were based on clinical studies with a follow-up of up to 2 years, and there have been few studies on the long-term results of aflibercept in clinical practice
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