Switch to Aflibercept in the Treatment of Neovascular XXXX : One-Year Results in Clinical Practice.

@entity1 @entity1020 @entity7
PURPOSE: To report the clinical outcomes of intravitreal aflibercept therapy in eyes with refractory and recurrent neovascular @entity1020 ( @entity1020 ) switched from intravitreal bevacizumab or ranibizumab. METHODS: This is a retrospective review of eyes with @entity1020 switched to intravitreal aflibercept with at least 1 year of follow-up after the switch. All @entity1 had had a minimum of 3 injections of bevacizumab or ranibizumab before the switch. Aflibercept was used in @entity1 considered refractory to bevacizumab (group 1) and in recurrent @entity1 on therapy with ranibizumab due to an institutional policy decision (group 2). Changes in best-corrected visual acuity, fluid on optical coherence tomography (OCT), central retinal thickness (CRT) and the frequency of injections were compared. RESULTS: Eighty-five eyes of 69 @entity1 were analyzed, 39 eyes in group 1 and 46 in group 2. The mean follow-up time was 31.6 months prior to the switch and 14.7 months on treatment with aflibercept. One year after the switch, there was a nonsignificant mean decrease of 2 letters in visual acuity in both groups (group 1: from 58.2 to 55.8 letters, p = 0.086; group 2: from 56.4 to 54.5 letters, p = 0.168), but the mean number of injections per month was significantly lower (from 0.76 to 0.57, p < 0.001). With the switch, 90.6% of the @entity1 showed anatomic improvement with a reduction of fluid on OCT, and both groups presented significant improvement in CRT (group 1: 65.3   m, p = 0.051; group 2: 91.0   m, p < 0.001). CONCLUSION: Aflibercept appears to be a valuable tool for the management of @entity1 with poor responses to other anti- @entity7 drugs. These @entity1 could have anatomic improvement, and the injection intervals could be extended.    2015 S. Karger AG, Basel.
