TY - JOUR
T1 - Short-term outcomes of aflibercept for neovascular age-related macular degeneration in eyes previously treated with other vascular endothelial growth factor inhibitors
AU - Ho, Vincent Y.
AU - Yeh, Steven
AU - Olsen, Timothy W.
AU - Bergstrom, Chris S.
AU - Yan, Jiong
AU - Cribbs, Blaine E.
AU - Hubbard, G. Baker
N1 - Funding Information:
All authors have completed and submitted the ICMJE form for disclosure of potential conflicts of interest and the following were reported. Dr Hubbard receives a consulting fee from the Children's Hospital of Philadelphia Research Institute as a consultant/expert reader for the Telemedicine Approaches to Evaluating Acute-Phase Retinopathy of Prematurity Study (eROP Study). He also has financial activity outside the submitted work involving expert witness testimony. There were no other financial disclosures from the remaining authors. Supported in part by an Unrestricted Grant from Research to Prevent Blindness , Inc, New York, New York; and by Core Grant EYO 6360 from the National Institutes of Health , Bethesda, Maryland. Involved in design and conduct of study (V.Y.H., S.Y., G.B.H.); collection (V.Y.H., S.Y., G.B.H., C.S.B., J.Y., B.E.C., T.W.O.), management (S.Y., G.B.H., T.W.O., C.S.B., J.Y., B.E.C.), analysis (V.Y.H., S.Y., G.B.H., T.W.O.), and interpretation (V.Y.H., G.B.H., S.Y., T.W.O.) of data; and preparation, review, or approval of the manuscript (V.Y.H., G.B.H., S.Y., T.W.O., C.S.B., J.Y., B.E.C.).
PY - 2013/7
Y1 - 2013/7
N2 - Purpose: To report results of aflibercept therapy in eyes with neovascular age-related macular degeneration previously treated with bevacizumab, ranibizumab, or both. Design: Retrospective, interventional, noncomparative, consecutive case series. Methods: Ninety-six eyes from 85 patients with neovascular age-related macular degeneration who previously had received bevacizumab, ranibizumab, or both were treated with aflibercept monthly for 3 months followed by a fourth injection within 2 months. Outcomes were determined 4 ± 1 months after the first aflibercept dose and included: proportion of patients gaining or losing 2 lines or more of best-corrected visual acuity, proportion remaining within a gain or loss of 1 line, mean change in logarithm of the minimal angle of resolution visual acuity, mean change in central foveal thickness, mean change in macular cube volume, and qualitative anatomic response as assessed by spectral-domain optical coherence tomography. Results: At baseline, 82 (85%) eyes had signs of active exudation despite a mean of 17 previous anti-vascular endothelial growth factor injections. At final visit, 82 (85%) remained stable within a gain or loss of 1 line, 7 (7%) gained 2 lines or more, and 7 (7%) lost 2 lines or more of best-corrected visual acuity. Mean logarithm of the minimal angle of resolution visual acuity showed minimal change 0.02 (range, -0.46 to 0.70; P =.14). Mean central foveal thickness decreased -18 μm (range, -242 to 198 μm; P =.06). Mean macular volume decreased -0.27 mm3 (95% confidence interval, -0.4 to -0.1 mm3; P =.004). On qualitative analysis, 4 (5%) eyes had complete resolution of exudative fluid, 40 (49%) showed partial resolution, 26 (32%) remained unchanged, and 12 (14%) showed worsened exudative fluid. Conclusions: Aflibercept seems to be an effective alternative for neovascular age-related macular degeneration patients previously treated with bevacizumab, ranibizumab, or both at 4 months of follow-up. Most treated eyes demonstrated stable visual acuity and anatomic improvements by spectral-domain optical coherence tomography.
AB - Purpose: To report results of aflibercept therapy in eyes with neovascular age-related macular degeneration previously treated with bevacizumab, ranibizumab, or both. Design: Retrospective, interventional, noncomparative, consecutive case series. Methods: Ninety-six eyes from 85 patients with neovascular age-related macular degeneration who previously had received bevacizumab, ranibizumab, or both were treated with aflibercept monthly for 3 months followed by a fourth injection within 2 months. Outcomes were determined 4 ± 1 months after the first aflibercept dose and included: proportion of patients gaining or losing 2 lines or more of best-corrected visual acuity, proportion remaining within a gain or loss of 1 line, mean change in logarithm of the minimal angle of resolution visual acuity, mean change in central foveal thickness, mean change in macular cube volume, and qualitative anatomic response as assessed by spectral-domain optical coherence tomography. Results: At baseline, 82 (85%) eyes had signs of active exudation despite a mean of 17 previous anti-vascular endothelial growth factor injections. At final visit, 82 (85%) remained stable within a gain or loss of 1 line, 7 (7%) gained 2 lines or more, and 7 (7%) lost 2 lines or more of best-corrected visual acuity. Mean logarithm of the minimal angle of resolution visual acuity showed minimal change 0.02 (range, -0.46 to 0.70; P =.14). Mean central foveal thickness decreased -18 μm (range, -242 to 198 μm; P =.06). Mean macular volume decreased -0.27 mm3 (95% confidence interval, -0.4 to -0.1 mm3; P =.004). On qualitative analysis, 4 (5%) eyes had complete resolution of exudative fluid, 40 (49%) showed partial resolution, 26 (32%) remained unchanged, and 12 (14%) showed worsened exudative fluid. Conclusions: Aflibercept seems to be an effective alternative for neovascular age-related macular degeneration patients previously treated with bevacizumab, ranibizumab, or both at 4 months of follow-up. Most treated eyes demonstrated stable visual acuity and anatomic improvements by spectral-domain optical coherence tomography.
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U2 - 10.1016/j.ajo.2013.02.009
DO - 10.1016/j.ajo.2013.02.009
M3 - Article
C2 - 23664153
AN - SCOPUS:84879209123
SN - 0002-9394
VL - 156
SP - 23-28.e2
JO - American Journal of Ophthalmology
JF - American Journal of Ophthalmology
IS - 1
ER -