Loading phase outcomes of intravitreal aflibercept 8 mg for treatment-naïve neovascular age-related macular degeneration

Purpose To investigate the efficacy and safety of loading phase treatment with 3 monthly intravitreal injections of aflibercept 8 mg for neovascular age-related macular degeneration (nAMD). Study design Retrospective, interventional case series. Methods We retrospectively analyzed 83 consecutive eyes of 80 patients with treatment-na & iuml;ve nAMD who received 3 monthly injections of aflibercept 8 mg as a loading phase treatment. Best-corrected visual acuity (BCVA), foveal thickness, central choroidal thickness (CCT), and dry macula achievement were all assessed every 4 weeks. Moreover, polypoidal lesion regression was evaluated after the loading phase. Results Seventy eyes (84.3%) of 67 patients completed the 3 monthly injections of aflibercept 8 mg. In these cases, BCVA was 0.33 +/- 0.45 at baseline and showed significant improvement to 0.22 +/- 0.38 at week 12 (P<0.01). Foveal thickness was 313 +/- 135<mu>m at baseline, decreasing significantly to 171 +/- 76 mu m at week 12 (P<0.01). CCT was 193 +/- 98<mu>m at baseline, decreasing significantly to 160 +/- 85 mu m at week 12 (P<0.01). Dry macula had been achieved in 58 (82.9%) of 70 eyes at week 12. Indocyanine green angiography after the loading phase revealed complete polypoidal lesion regression in 16 of 22 eyes (72.7%) with polypoidal lesions. Among the 13 eyes (15.7%) not completing the loading phase treatment, 9 (10.8%) developed non-infectious intraocular inflammation (IOI) associated with retinal vasculitis and aflibercept 8 mg administration was thus discontinued. Conclusions Loading phase treatment with intravitreal aflibercept 8 mg appears to be effective for improving visual acuity and ameliorating exudative changes in eyes with nAMD. However, careful monitoring is required due to the potential development of IOI associated with retinal vasculitis.