Response to aflibercept after frequent re-treatment with bevacizumab or ranibizumab in eyes with neovascular AMD

Mariana R. Thorell, Renata Portella Nunes, Gene W. Chen, Rishi R. Doshi, Jyoti Dugar, Mathew K. George, Brian T. Kim, Matthew D. Lowrance, Dimple Modi, Zayna Nahas, Giovanni Gregori, Zohar Yehoshua, William Feuer, Philip J. Rosenfeld

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31 Scopus citations


BACKGROUND AND OBJECTIVE: To evaluate the effects of switching to aflibercept in eyes with neovascular age-related macular degeneration (AMD) requiring frequent re-treatment with bevacizumab or ranibizumab. PATIENTS AND METHODS: Retrospective review of 73 eyes of 65 patients with neovascular AMD switched to aflibercept due to persistent or recurrent macular fluid after at least 1 year of intravitreal bevacizumab or ranibizumab with re-treatment at least every 6 weeks. Minimum post-switch follow-up was 6 months. All patients were treated using a treat-and-extend strategy. The treatment intervals immediately after and before the switch were the same. RESULTS: The mean pre-switch anti-VEGF therapy duration was 45 months, and the mean number of injections was 31. In the 6 months after the switch, the average number of injections was reduced by 0.6 compared with the 6 months before the switch (P <.001). Visual acuity was unchanged during this period (P =.78). Central retinal thickness (CRT) decreased by 19 μm after the switch (P <.001). Seventy eyes had vascularized retinal pigment epithelial detachments (PEDs). The decrease in the PED cube-root volume during the 6 months after the switch was statistically significant (-0.07 mm; P =.007). CONCLUSION: The number of injections, CRT, and PED volume decreased significantly after the switch to aflibercept, but visual acuity was unchanged.

Original languageEnglish (US)
Pages (from-to)526-533
Number of pages8
JournalOphthalmic Surgery Lasers and Imaging Retina
Issue number6
StatePublished - Nov 1 2014

ASJC Scopus subject areas

  • Surgery
  • Ophthalmology


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