Baseline Optical Coherence Tomography Findings as Outcome Predictors after Switching from Ranibizumab to Aflibercept in Neovascular Age-Related Macular Degeneration following a Treat-and-Extend Regimen

Ophthalmologica. 2017;238(3):172-178. doi: 10.1159/000477856. Epub 2017 Aug 4.

Abstract

Purpose: To evaluate outcome predictors of aflibercept in neovascular age-related macular degeneration pretreated with ranibizumab based on a treat-and-extend regimen (TER).

Methods: We performed a retrospective evaluation of 18-month follow-up of 45 consecutive patients with limited response to ranibizumab.

Results: At month 18, mean central retinal thickness and intraretinal fluid (IRF) height were significantly reduced. The recurrence-free treatment interval (RFTI) increased from 7.0 ± 1.8 to 8.5 ± 2.4 weeks (p = 0.01); visual acuity remained stable. At month 18, 58.1% of patients showed a longer RFTI. At month 12, eyes with baseline subretinal fluid (SRF) had a shorter RFTI than those without SRF (p = 0.032). Eyes with baseline IRF showed a longer RFTI than those without IRF (p = 0.037). Baseline hyperreflective foci (HRF) presence indicated improvement in SRF (p = 0.024) and IRF at month 12 (p = 0.049).

Conclusion: Baseline HRF presence predicted better morphological outcome, while SRF predicted a shorter RFTI and IRF a longer RFTI after switching from ranibizumab to aflibercept within a TER.

Keywords: Aflibercept; Anti-vascular endothelial growth factor; Hyperreflective foci; Neovascular age-related macular degeneration; Optical coherence tomography; Ranibizumab.

MeSH terms

  • Angiogenesis Inhibitors / administration & dosage
  • Drug Substitution
  • Female
  • Follow-Up Studies
  • Humans
  • Intravitreal Injections
  • Macula Lutea / pathology*
  • Male
  • Ranibizumab / administration & dosage*
  • Receptors, Vascular Endothelial Growth Factor / administration & dosage*
  • Receptors, Vascular Endothelial Growth Factor / antagonists & inhibitors
  • Recombinant Fusion Proteins / administration & dosage*
  • Retrospective Studies
  • Time Factors
  • Tomography, Optical Coherence / methods*
  • Treatment Outcome
  • Visual Acuity*
  • Wet Macular Degeneration / drug therapy

Substances

  • Angiogenesis Inhibitors
  • Recombinant Fusion Proteins
  • aflibercept
  • Receptors, Vascular Endothelial Growth Factor
  • Ranibizumab