Aflibercept Treatment for Neovascular Age-related Macular Degeneration and Polypoidal Choroidal Vasculopathy Refractory to Anti-vascular Endothelial Growth Factor.
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.
['Moon|Da Ru Chi|DRC|', 'Lee|Dong Kyu|DK|', 'Kim|Soon Hyun|SH|', 'You|Yong Sung|YS|', 'Kwon|Oh Woong|OW|']
D020533:Angiogenesis Inhibitors D000068258:Bevacizumab D002829:Choroid D015862:Choroid Diseases D004305:Dose-Response Relationship, Drug D004359:Drug Therapy, Combination D005260:Female D005500:Follow-Up Studies D006801:Humans D058449:Intravitreal Injections D008297:Male D000069579:Ranibizumab D040262:Receptors, Vascular Endothelial Growth Factor D011993:Recombinant Fusion Proteins D015861:Retinal Neovascularization D012189:Retrospective Studies D041623:Tomography, Optical Coherence D016896:Treatment Outcome D042461:Vascular Endothelial Growth Factor A D014792:Visual Acuity D057135:Wet Macular Degeneration
Aflibercept Macular degeneration Polypoidal choroidal vasculopathy Anti-vascular endothelial growth factor Bevacizumab