KMID : 0360220230640040313
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Journal of the Korean Ophthalmological Society 2023 Volume.64 No. 4 p.313 ~ p.322
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Course of Neovascular Age-related Macular Degeneration that Showed Limited Response to Both Ranibizumab and Aflibercept
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Yun Jeong-Seop
Kim Chul-Gu Kim Jong-Woo Kim Jae-Hui
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Abstract
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Purpose: To evaluate the clinical course of neovascular age-related macular degeneration (nAMD) that has shown limited response to ranibizumab and aflibercept.
Methods: This retrospective study included 14 eyes with nAMD that showed a limited response to initial treatment using ranibizumab and aflibercept. The changes in visual acuity (VA) during the follow-up period and the incidence and timing of VA deterioration to the level of 0.1 or worse were identified. In cases involving bevacizumab treatment, the follow-up duration and the proportion of patients maintaining a VA of 0.2 or better were identified.
Results: During the mean 43.3 ¡¾ 33.2 months of follow-up, the VA deteriorated significantly from a mean logarithm of minimum angle of resolution (logMAR) of 0.42 ¡¾ 0.34 at diagnosis to 0.91 ¡¾ 0.68 at the final follow-up (p = 0.021). A logMAR of 0.3 or greater degree of VA deterioration was noted in six eyes (42.9%). Among the 13 eyes exhibiting a VA of 0.2 or better after the initial treatment, a deterioration to a VA of 0.1 or worse was noted in 6 eyes (46.2%) at a mean 29.7 ¡¾ 18.3 months. In eight eyes undergoing bevacizumab treatment, four eyes (50.0%) maintained 0.2 or better VA during the 51.4 ¡¾ 35.5 months of follow-up.
Conclusions: The clinical course of patients with limited response to ranibizumab and aflibercept was generally unfavorable.
However, a relatively long period was required for the deterioration in VA to reach 0.1 or worse. In addition, 0.2 or better VA was maintained in approximately half of the patients.
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KEYWORD
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Aflibercept, Age-related macular degeneration, Ranibizumab
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