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KMID : 0213520150290040226
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Korean Journal of Ophthalmology
2015 Volume.29 No. 4 p.226 ~ p.232
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Aflibercept Treatment for Neovascular Age-related Macular Degeneration and Polypoidal Choroidal Vasculopathy Refractory to Anti-vascular Endothelial Growth Factor
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Moon Da Ru Chi
Lee Dong-Kyu
Kim Soon-Hyun
You Yong-Sung
Kwon Oh-Woong
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Abstract
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Purpose: To report the results of switching treatment to vascular endothelial growth factor (VEGF) Trap-Eye (aflibercept) in neovascular age-related macular degeneration (AMD) and polypoidal choroidal vasculopathy (PCV) refractory to anti-VEGF (ranibizumab and bevacizumab).
Methods: This is a retrospective study involving 32 eyes from 29 patients; 18 were cases of neovascular AMD and 14 were cases of PCV. The best-corrected visual acuity (BCVA) and central macular thickness (CMT) of spectral-domain optical coherence tomography were evaluated.
Results: BCVA and CMT improved from 0.58 to 0.55 (p = 0.005) and from 404 to 321 μm (p < 0.001), respectively, after switching to aflibercept. The 14 eyes that received 6 or more aflibercept injections remained stable at 0.81 to 0.81 and 321 to 327 μm (p = 1.0, 0.29), respectively, after 3 aflibercept injections. The 10 eyes that received 3 or more bevacizumab injections after 3 or more aflibercept injections worsened, from 0.44 to 0.47 and from 332 to 346 μm (p = 0.06, 0.05), respectively. The results showed similar improvement of BCVA and CMT in neovascular AMD and PCV.
Conclusions: Aflibercept seems to be effective for improvement and maintenance of BCVA and CMT for neovascular AMD and PCV refractory to anti-VEGF. Switching from aflibercept back to bevacizumab treatment may not be a proper strategy.
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KEYWORD
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Aflibercept, Anti-vascular endothelial growth factor, Bevacizumab, Macular degeneration, Polypoidal choroidal vasculopathy
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