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Evaluation of outer retinal tubulations in eyes switched from intravitreal ranibizumab to aflibercept for treatment of exudative age-related macular degeneration

  • Retinal Disorders
  • Published:
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Abstract

Purpose

To evaluate the changes of outer retinal tubulations (ORTs) as seen on spectral-domain optical coherence tomography (SD OCT) in eyes with neovascular age-related macular degeneration (AMD) where treatment was switched from intravitreal ranibizumab to intravitreal aflibercept.

Methods

This was a prospective study of eyes diagnosed with neovascular AMD and previously treated with >6 intravitreal ranibizumab injections and switched to aflibercept, conducted at a single centre (Department of Ophthalmology at Pitié Salpetriere Hospital, Paris VI University) from January to July 2015. Before and after treatment was switched from ranibizumab to aflibercept, SD-OCT was used to evaluate the presence of ORTs. Additional assessments in this patient group included best-corrected visual acuity (BCVA), fluorescein angiography (FA), indocyanine green angiography (ICGA). Changes in pigment epithelium detachments (PED), presence of intraretinal cysts, and presence of subretinal fluid (SRF) were also noted.

Results

Twenty-four eyes of 24 consecutive patients (15 female/nine male, mean age 70 years) diagnosed with neovascular AMD and previously treated with >6 intravitreal ranibizumab injections and switched to aflibercept were included in the analysis. After receiving aflibercept, patients were followed for a mean of 6.1 months. Prior to treatment switch, 97 % of eyes showed ORTs, while after treatment switch to aflibercept, at the end of the study period, 75 % had ORTs (p =  0.219). Changes in BCVA (LogMAR) were not statistically significant (1.16 ± 0.44 to 1.18 ± 1.06, p =  0.12), however, a significant reduction in central macular thickness (CMT) (from 406 μm ± 112 to 263 μm ± 68, p =  0.001), PED (from 70.8 % to 41.7 % , p =  0.016), presence of intraretinal cysts (from 83.3 % to 33.3 %, p =  0.002) and SRF (from 91.7 % to 25 %, p = 0.001 ) were noted.

Conclusion

After switching from ranibizumab treatment to aflibercept, ORTs remained present in 75 % of eyes, and significant reductions in CMT, PED, and SRF, and presence of intraretinal cysts were observed.

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Acknowledgments

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors

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Authors and Affiliations

  1. Department of Ophthalmology, Pitié salpetrière Hospital, UPMC, Paris, France

    Nathalie Massamba, Nathalie Butel, Christine Fardeau, Bahram Bodaghi, April Ingram & Phuc Lehoang

  2. Department of Ophthalmology, University of Lausanne, Lausanne, Switzerland

    Ali Dirani

  3. Fondation Asile des Aveugles (Foundation Asylum for the Blind), Jules Gonin Eye Hospital, Lausanne, Switzerland

    Ali Dirani

  4. Department of Ophthalmology, University Paris VI GH Pitié Salpétrière, 47–83 Boulevard de l’hôpital 75013, Paris, France

    April Ingram

Authors
  1. Nathalie Massamba
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  2. Ali Dirani
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  4. Christine Fardeau
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  5. Bahram Bodaghi
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Corresponding author

Correspondence to April Ingram.

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Financial disclosures

None for any author.

Author contributions in each of these areas: design and conduct of the study (NM, BB); data collection, management, analysis (NM, AD); interpretation of data (AD, NM); and preparation (NM, NB, CF), review, or approval of the manuscript (BB,PL).

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No funding was received for this research.

Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge, or beliefs) in the subject matter or materials discussed in this manuscript.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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The authors have no proprietary interest in the materials used in this study.

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Massamba, N., Dirani, A., Butel, N. et al. Evaluation of outer retinal tubulations in eyes switched from intravitreal ranibizumab to aflibercept for treatment of exudative age-related macular degeneration. Graefes Arch Clin Exp Ophthalmol 255, 61–67 (2017). https://doi.org/10.1007/s00417-016-3423-x

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  • DOI: https://doi.org/10.1007/s00417-016-3423-x

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