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Clinical outcomes after switching treatment from intravitreal ranibizumab to aflibercept in neovascular age-related macular degeneration

  • Retinal Disorders
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To describe the treatment response to aflibercept in patients with exudative age-related macular degeneration that showed insufficient or diminishing treatment effects under ranibizumab.

Methods

From December 2012 till June 2013 all patients receiving intravitreal injections of aflibercept after previous treatment with ranibizumab were collected in a database and retrospectively reviewed. Clinical data such as visual acuity or central subfield retinal thickness on optical coherence tomography (OCT) scans were analyzed for the time frame before, during, and shortly after the aflibercept injections. Of particular interest was the comparison of clinical features under ongoing ranibizumab treatment to the time during aflibercept treatment.

Results

Seventy-one eyes of 65 patients were included in the study. All eyes had previous ranibizumab injections in their medical history, the average number of which was nine (range 3-43). For the total group the mean visual acuity (VA) before the first ranibizumab injection was 0.54 logMAR, and after the last ranibizumab injection was 0.57 logMAR. Mean VA changed from 0.47 logMAR before the first aflibercept injection to 0.25 logMAR after the last aflibercept injection. Central subfield retinal thickness (CSRT) on OCT changed from a mean of 417.28 μm to 349.52 μm under ranibizumab treatment and from 338.76 μm to 272.00 μm under aflibercept treatment. Interestingly, 33 % of cases that did not show a functional improvement under ranibizumab therapy gained visual acuity after aflibercept treatment.

Conclusion

Aflibercept appears to be an effective choice for patients with neovascular age-related macular degeneration who were resistant to previous therapy of ranibizumab. The longevity of this effect still remains questionable.

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Abbreviations

OCT:

Optical coherence tomography

SD-OCT:

Spectral-domain OCT

FA:

Fluorescein angiography

VA:

Visual acuity

AMD:

Age-related macular degeneration

CSRT:

Central subfield retinal thickness

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Disclosure

Dr. Florian Heussen receives research support from Novartis and Heidelberg Engineering. He also serves as a consultant for Allergan Inc. Dr. Antonia Joussen receives financial compensation for lectures from Novartis Inc., Allergan Inc., and Bayer Inc.

Conflict of interest

The authors have no conflict of interest.

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Authors and Affiliations

  1. Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany

    Florian M. Heussen, Qing Shao, Yanling Ouyang, Antonia M. Joussen & Bert Müller

  2. Department of Ophthalmology, Shanghai First People’s Hospital, Shanghai, China

    Qing Shao

Authors
  1. Florian M. Heussen
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  2. Qing Shao
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  3. Yanling Ouyang
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  4. Antonia M. Joussen
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  5. Bert Müller
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Corresponding author

Correspondence to Florian M. Heussen.

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Heussen, F.M., Shao, Q., Ouyang, Y. et al. Clinical outcomes after switching treatment from intravitreal ranibizumab to aflibercept in neovascular age-related macular degeneration. Graefes Arch Clin Exp Ophthalmol 252, 909–915 (2014). https://doi.org/10.1007/s00417-013-2553-7

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  • DOI: https://doi.org/10.1007/s00417-013-2553-7

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