Aflibercept in refractory wet AMD treated with ranibizumab: Anatomical and visual outcome

Purpose: To assess the anatomical outcome of patients with exudative age-related macular degeneration resistant to ranibizumab treated with aflibercept. Method: Prospective, interventional, case series, where we treated a group of patients deemed resistant to Ranibizumab after 6 months of persistence of intra-or subretinal fluid despite continuous treatment. Results: The study included 17 patients, 3 males and 14 females. The average males age was 85 (range 83-87), and that of females was 79.64 (range 68-88). At the start of the study, the central foveal thickness CFT average was 534.76 mu m (range 252-999). At 1 month and after 1 injection of Aflibercept, the CFT average was 324.82 mu m (range 222-585). At 4 months and after 3 consecutive injections of Aflibercept the CFT average was 294.76 mu m (range 184-640). At 6 months the CFT average was 356 mu m (range 206-609). At the 5th visit only 8 out 17 (47%) patients required repeated injection either for persistent fluids or for recurrence. At the 6th and final visit only 4 out of 17 (23.5%) needed repeated injections, of them only one was treated on the visit before and treatment was given as very little response was observed from last injection, and all other 3 were not treated on the visit before. Conclusion: Our results showed that aflibercept was able to dry the macula even in advanced case of wet AMD resistant to Ranibizumab.