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Assessing the Anatomical and Functional Efficacy of Aflibercept on Wet ARMD: An OCT and Mferg Recording
摘要： Objective: To investigate the therapeutic efficacy of aflibercept on sub-foveal choroidal neovascularization due to Age-Related Macular Degeneration (ARMD). Methods: Fifteen patients (15 eyes) with sub-foveal choroidal neovascularization due to ARMD were treated with intravitreal aflibercept. The doses were monthly for the first three months, being repeated every three months after for one year, using 2 mg of intravitreal aflibercept. A total of six aflibercept injections were, finally, performed during the 12-month study. All patients underwent a complete ophthalmic examination, including the measurement of best-corrected visual acuity, fundus examination, intraocular pressure measurement, fluorescein angiography, optical coherence tomography (OCT) scan and multifocal electroretinography (mfERG) recording, at the baseline and at the first, second, third, sixth, ninth and 12th month after the first injection of aflibercept. Two masked examiners evaluated the visual acuity based on standard Snellen charts. Results: Fifteen patients (15 eyes), of mean age 69.2 ± 4.9 years old, with sub-foveal choroidal neovascularization due to ARMD were participated in this study. The mean BCVA was 0.12 ± 0.08, 0.20 ± 0.10, 0.25 ± 0.1, 0.28 ± 0.1, 0.34 ± 0.14, 0.36 ± 0.14 and 0.40 ± 0.14 decimal, at presentation, 1st, 2nd, 3rd, 6th, 9th and 12th month, respectively. Significant differences in amplitudes but not in latencies of three rings were observed over time. Significant reductions were noted among the central retinal thickness measurements before intravitreal aflibercept and at 1st, 2nd, 3rd, 6th, 9th and 12th month (465.0 ± 161.4, 374.9 ± 139.5, 323.3 ± 113.8, 290.3 ± 85, 263.3 ± 69, 243.0 ± 60.6 and 226.9 ± 63.5, respectively). Conclusion: This is the first time that anatomical and functional improvement of the macula in patients with sub-foveal choroidal neovascularization due to ARMD was shown objectively, based on OCT and mfERG recordings. In addition, the improvement of visual acuity was noted over time. Our study supports the fact that intravitreal use of aflibercept is safe and effective in treating sub-foveal choroidal neovascularization observed in patients with ARMD.
关键词： findings,electroretinography,Macular,Aflibercept,Anatomical,Sub-foveal,Multifocal,Optical coherence tomography,choroidal neovascularization,Function,Age-related macular degeneration
更新于2025-09-09 09:28:46
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A single-arm, investigator-initiated study of the efficacy, safety, and tolerability of intravitreal aflibercept injection in subjects with exudative age-related macular degeneration previously treated with ranibizumab or bevacizumab (ASSESS study): 12-month analysis
摘要： In subjects with active exudative age-related macular degeneration, treating with a fixed intravitreal aflibercept injection dosing regimen for 12 months demonstrated improved anatomic and vision endpoints from baseline. Purpose: Switching therapies in neovascular age-related macular degeneration (AMD) may offer an advantage for some patients. This study evaluates the efficacy of intravitreal aflibercept injection (IAI) in subjects previously treated with ranibizumab and/or bevacizumab. Methods: Subjects (n=26) were given monthly 2 mg of IAI for 3 months, followed by 2 mg once in every 2 months for up to 12 months. The mean absolute change from baseline in central subfield thickness (CST) measured by optical coherence tomography and the mean change from baseline in best-corrected visual acuity (BCVA) early treatment in diabetic retinopathy study (ETDRS) letter score were obtained. Additionally, the percentage of subjects who gained or lost $15 letters of vision and the percentage of subjects who are 20/40 or better or 20/200 or worse were evaluated. Results: There was a mean decrease in CST of ?50.3 μm (P,0.001) and a mean increase in ETDRS BCVA of +9.2 letters (P,0.001). Twenty-seven percent of subjects experienced a $15-letter improvement in visual acuity, and no subject lost $3 lines of vision from baseline. Fifty percent of subjects were 20/40 or better, and 11.5% of subjects were 20/200 or worse at month 12. Conclusion: Fixed IAI dosing regimen for 12 months demonstrated improved anatomic and vision endpoints in subjects with active exudative AMD.
关键词： bevacizumab,aflibercept,vascular endothelial growth factors,ranibizumab,age-related macular degeneration
更新于2025-09-09 09:28:46
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One-year outcome of intravitreal aflibercept injection for age-related macular degeneration resistant to ranibizumab: rapid morphologic recovery and subsequent visual improvement
摘要： Objective: To describe the 1-year efficacy of aflibercept in Japanese patients with age-related macular degeneration (AMD) who were resistant to ranibizumab treatment. Design: Retrospective case series. Participants: Fourteen consecutive eyes of 14 patients with AMD were enrolled who had no substantial response or developed resistance to intravitreal ranibizumab injections. Methods: All patients were subcategorized into one of two subtypes of AMD: seven patients with occult choroidal neovascularization (CNV) and seven with polypoidal choroidal vasculopathy (PCV). Serial intravitreal aflibercept (IVA) injections were administered. Comprehensive ophthalmic examinations, including optical coherence tomography, were conducted at baseline and at follow-up examinations at 1, 3, 6, and 12 months after the initial IVA injection. The best-corrected visual acuity converted to logarithm of the minimum angle of resolution (logMAR) and central macular thickness (CMT) at each follow-up visit were compared with the baseline values. The anatomic response was also assessed with absorption or reduction of fluid in the subretina or subretinal pigment epithelial space. Results: The logMAR best-corrected visual acuity improved significantly at 3, 6, and 12 months in the total cohort: at 3 and 6 months in patients with occult CNV and at 3 and 12 months in patients with PCV. The CMT decreased significantly at all follow-up visits in the total cohort as well as in both subtypes, except for the CMT at 6 months in PCV patients. The anatomic improvement was also demonstrated in all cases, and pigment epithelial detachments tended to be resolved more rapidly in patients with PCV than in patients with occult CNV. Conclusion: Conversion to IVA was effective in patients with AMD resistant to ranibizumab, showing rapid morphologic improvement. The logMAR visual acuity was raised significantly within 12 months, and the clinical course of visual acuity improvement may differ according to the AMD subtypes.
关键词： polypoidal choroidal vasculopathy,aflibercept,occult choroidal neovascularization,ranibizumab,resistance,age-related macular degeneration
更新于2025-09-04 15:30:14