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摘要
Purpose: To study the visual outcomes and change in central macular thickness (CMT) in patients with neovascular age-related macular degeneration (AMD) who were previously treated with ranibizumab (Lucentis) and/or bevacizumab (Avastin) and were subsequently switched to aflibercept (VEGF Trap-Eye; Eylea). Methods: Retrospective study of patients who received intravitreal aflibercept from December 2011 to December 2012 and had previous anti-vascular endothelial growth factor treatment for AMD. The main outcome measures were best-corrected visual acuity (BCVA) and CMT as measured by optical coherence tomography. Results: The study population included 30 patients aged 80.41.45 (mean +/- SEM) who received 6.27 +/- 0.37 (range 4-11) aflibercept injections. Eighteen patients had previously received only bevacizumab (12.4 +/- 2.18 injections), 2 had received only ranibizumab (19 +/- 6 injections), and 10 had received both ranibizumab and bevacizumab (mean 19.3 injections). BCVA logMAR at the initial visit (aflibercept initiation) was 0.506 +/- 0.054 (mean VA 20/64), and then, follow ups at 1-month 0.504 +/- 0.055 (20/64) P=0.903, 3-months 0.458 +/- 0.061 (20/57) P=0.112, 6-months 0.413 +/- 0.071 (20/52) P=0.036, and 12-months 0.521 +/- 0.076 (20/66) P=0.836. CMT at the initial visit was 261 +/- 10.9, and then, at 1-month 238 +/- 12.4 P=0.021, 3-months 245 +/- 10.6 P=0.102, 6-months 245 +/- 10.4 P=0.099, and 12-months 237 +/- 10.2 P=0.012. Results were similar in a subset of patients (n=15) with central macular edema or submacular fluid at aflibercept initiation. While on aflibercept, 2 patients developed intraocular pressure increases that required treatment. Conclusions: These findings demonstrate a significant decrease in CMT but no statistically significant improvement in BCVA through the 12-month follow up in patients previously treated who were switched to aflibercept for AMD. Patients may develop ocular hypertension after multiple aflibercept injections.
- 出版日期2014-5-1
