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The short‐term effects of aflibercept on the size of choroidal neovascularization lesion in treatment‐resistant neovascular age‐related macular degeneration as determined by spectral‐domain optical coherence tomography
Author(s) -
Abri Aghdam Kaveh,
Seidensticker Florian,
Pielen Amelie,
Framme Carsten,
Junker Bernd
Publication year - 2016
Publication title -
lasers in surgery and medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.888
H-Index - 112
eISSN - 1096-9101
pISSN - 0196-8092
DOI - 10.1002/lsm.22531
Subject(s) - aflibercept , choroidal neovascularization , macular degeneration , medicine , ranibizumab , ophthalmology , lesion , fluorescein angiography , visual acuity , optical coherence tomography , bevacizumab , surgery , chemotherapy
Background and Objectives To evaluate the changes in the size of choroidal neovascularization (CNV) lesion using spectral domain‐optical coherence tomography (SD‐OCT) in patients with treatment‐resistant neovascular age‐related macular degeneration (AMD) who were switched from ranibizumab to aflibercept. Materials and Methods In this prospective case‐series, 33 eyes of 30 patients with treatment‐resistant neovascular AMD were included. Treatment‐resistant neovascular AMD was defined as choriodal neovascularization secondary to AMD determined by subretinal fluid and/or intraretinal fluid/cysts after more than 6 months of monthly ranibizumab therapy. Enrolled eyes were received intravitreal aflibercept injections at weeks 0, 4, and 8. Maximum area of CNV lesion in the cross‐sectional area in the B‐scan was measured using Heidelberg Eye Explorer software. The same cross‐sectional sections containing maximum area of CNV lesion were used during the follow‐up. CNV subtypes were determined based on fluorescein angiography images prior to ranibizumab therapy. Main outcome measures were changes in best‐corrected visual acuity (BCVA), central subfield thickness (CST), and area of CNV lesion. Results There were five classic (15%), seven minimally classic (21%), and 21 occult subtypes of CNV (64%). Four weeks after the third injection, BCVA improvement and reduction of the retinal thickness in nine standard ETDRS subfields were significant (both P < 0.001). Regarding and regardless of CNV subtypes, mean area of CNV lesion decreased significantly at final visit. Overall, a dry macula was achieved in 21 eyes (64%) and 12 eyes (36%) showed decreased or unchanged edema. Conclusions Switching to aflibercept seems to result in reduction of CNV lesion area in short‐term follow‐up of patients with treatment‐resistant neovascular AMD. Lasers Surg. Med. 48:668–677, 2016. © 2016 Wiley Periodicals, Inc.