Clinical efficacy of aflibercept treatment in patients with ranibizumab-resistant neovascular age-related macular degeneration

Abstract

THE AIM was to evaluate clinical efficacy of aflibercept treatment in patients with ranibizumab-resistant neovascular age-related macular degeneration.

MATERIALS AND METHODS. 13 patients (13 eyes) after intravitreal ranibizumab therapy for 1 year (from 6 to 8 injections with an interval of 1.5 to 2 months). However, in all patients, there was a recurrence of the exudative activity of the process. Aflibercept treatment method consisted of 3 monthly “loading” intravitreal injections with follow-up period of 4 months.

RESULTS. One month after 1st aflibercept injection among all patients, the average index of best-corrected visual acuity (BCVA) increased to 0.41 ± 0.02 and the central retinal thickness (CRT) index decreased to 307 ± 14.5 μm versus the initial CRT value 431 ± 64 μm. After the 3rd aflibercept injection, the CRT index was the lowest and amounted to 189.5 ± 13.0 μm, which was accompanied BCVA increase to 0.42 ± 0.03 versus 0.29 ± 0.05 as the initial value. According to the optical coherence tomography data, after “loading” phase, good anatomical effect was observed with significant edema reduction, complete resorption of fluid in the subretinal space, and decrease of the pigment epithelial detachment’s height.

CONCLUSION. Evaluating the results of our study, we found that the use of angiogenesis inhibitor aflibercept made it possible to suppress the signs of activity of choroidal neovascularization and to obtain additional improvement of visual functions in patients with neovascular age-related macular degeneration, when the therapeutic effect from the early ranibizumab therapy was insufficient or completely absent.

Keywords

neovascular age-related macular degeneration / aflibercept / ranibizumab / tachyphylaxis

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RIGHTS & PERMISSIONS

Egorov V.V., Smoliakova G.P., Danilova L.P., Zhajvoronok N.S., Solov'yeva Y.B., Polosina A.N.