APR 27, 2015
Retina/Vitreous
What’s the real-world effect of aflibercept in a clinical setting? To find out, the authors of this study recruited 98 consecutive patients with treatment-naïve AMD and treated them every 2 months for 8 weeks.
They drew 3 conclusions from their data:
- Treatment is effective in patients with polypoidal choroidal vasculopathy (PCV) and in retinal angiomatous proliferation (RAP).
- Even in patients with good baseline visual acuity, visual gain is as good as in clinical trials.
- Factors that predict good visual outcome included the presence of external limiting membrane (ELM), smaller greatest linear dimension and the presence of polypoidal lesion.
Subjects included 46 patients with typical AMD, 42 with PCV and 10 with RAP, all of whom underwent 3 courses of monthly injections and subsequent bi-monthly injections of aflibercept (2.0 mg). At 12 months, mean logMAR improved from 0.36 to 0.21 in 12.
The authors recommend aflibercept for any AMD subtype, even though patients with RAP did not show an improvement in visual acuity at 12 months. They attribute this finding to good baseline visual acuity and the relatively small number of patients enrolled with RAP.
Nearly 70% of patients with PCV achieved a favorable rate of polypoidal lesion closure, and they achieved significantly better final visual acuity compared with AMD patients (P=0.016). Because PDT monotherapy is accompanied by severe complications, the authors conclude that aflibercept monotherapy is better than PDT monotherapy, not only to achieve better visual outcome but also to induce polyp regression.