The efficacy of treatment with aflibercept intravitreal injections in patients with wet age-related macular degeneration

Anna Heinke; Katarzyna Michalska-Malecka

Volume : IX, Issue : IV, April - 2020

The efficacy of treatment with aflibercept intravitreal injections in patients with wet age-related macular degeneration

Anna Heinke, Katarzyna Michalska Malecka

Abstract :

Purpose: The aim of this study was to evaluate the effectiveness and safety of treatment with aflibercept administered intravitreally in patients with neovascular age-related macular degeneration after first year of treatment. Moreover, the influence of following factors on therapeutic success with aflibercept was investigated: CNV type, lens status (pseudophakic vs phakic), patient�s age, sex and the fact if patient was previously receiving anty-VEGF injections. Methods: A prospective clinical study was conducted on 90 eyes of patients (age 56 to 89 years old, 50 females, 40 males) who were diagnosed with choroidal neovascularisation (CNV) due to wet AMD. Before each injection best corrected visual acuity(BCVA) on Snellen chart, converted then to ETDRS scale for statistical purposes and central retinal thickness (CRT) using optical coherence tomography (OCT) were assessed. All patients received 3 doses of 2,0 mg intravitreal aflibercept every 4 weeks, followed by aflibercept injections every 2 months. The primary endpoint of the study was determined on best corrected visual acuity (BCVA) and changes observed in central retinal thickness (CRT) 3 months and 1 year after treatment with aflibercept comp� with BCVA and OCT at the baseline. Results: After the first year of treatment with aflibercept a statistically significant improvement of mean BCVA was observed. The patients gained +2,47 letters (Z=-1,989; p<0,05) after 3 months and +9,29 letters (Z=-6,812; p<0,001) in ETDRS scale after 52 weeks of treatment. At the same time a statistically significant reduction of CRT in OCT was observed. The mean CRT decreased from 370,38 μm to 300,76μm after 52 weeks of treatment (p<0,001). Intravitreal injections were well tolerated and no serious local or general adverse events were recorded. The baseline visual acuity was the most important predictor for final BCVA after the treatment (r=-0,421; p<0,01). The subtype of CNV, patient`s sex, lens status (phakic vs pseudophakic) and therapy type (previous anty-VEGF treatment vs treatment-na�ve patients) did not correlate with final BCVA. Conclusions: The intravitreal therapy with aflibercept is effective and safe for treating patients with wet AMD in routine daily practice. The obtained results proves the efficacy of treatment with aflibercept in patients with wet AMD and indicate the importance of early diagnose and treatment implementation to obtain the best functional and morphological results.