Intravitreal aflibercept in neovascular age-related macular degeneration previously treated with ranibizumab

AIM:To report the change in visual acuity and central macular thickness(CMT)following treatment with intravitreal aflibercept injections in patients with neovascular agerelated macular degeneration(n AMD)with suboptimum response to ranibizumab.METHODS:This was a retrospective study. The inclusion criteria were patients with n AMD who responded poorly to ranibizumab. Patients then received either 3 consecutive aflibercept injections followed by pro re nata(PRN)treatment or PRN alone. Primary endpoints were mean change in bestcorrected visual acuity(BCVA)and CMT at 12 mo. Secondary endpoints were number of injections and adverse events.RESULTS:Forty-nine eyes from 49 patients met the inclusion criteria and completed 12-month follow up on aflibercept. Thirty-eight eyes received 3 consecutive aflibercept injections followed by PRN treatment and 11 eyes received PRN injections alone. At 12 mo,mean BCVA improved by one letters(log MAR 0.56±0.31 to 0.54±0.34)and mean CMT decreased from 303.9±82.1 to 259.2±108.3 μm.Four percent of eyes gained 15 letters or more,6% lost more than 15 letters and the remaining 90% had stable BCVA. The mean number of aflibercept injections was 6.There was one case of infectious endophthalmitis.CONCLUSION:Intravitreal aflibercept in patients with n AMD with a previous suboptimal response to ranibizumab resulted in an anatomical improvement in macular appearance at 12 mo without a corresponding improvement in visual acuity.