Efficacy and Safety of Aflibercept for the Treatment of Idiopathic Choroidal Neovascularization in Young Patients

Kodjikian, Laurent; Tadayoni, Ramin; Souied, Eric H.; Baillif, Stéphanie; Milazzo, S.; Dumas, Stéphane; Uzzan, J.; Bernard, Laure; Decullier, Évelyne; Huot, Laure; Mathis, Thibaud

doi:10.1097/iae.0000000000003310

Cited by 4 publications

(5 citation statements)

References 38 publications

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“…There were no serious side effects related to IVA injection. In congruence with the safety reports of IVA by Korol et al [ 12 ], Gliem et al [ 13 ], and the INTUITION study [ 8 ], we did not detect any ocular or systemic side effects associated with IVA injection in the present study. Our results corroborate those of the fore-mentioned studies and support the notion that the damage induced to the RPE-Bruch’s membrane complex by certain fundus disorders with secondary CNV formation is self-limiting compared to the chronic progressive pathology of nAMD [ 14 ].…”

Section: Discussionsupporting

confidence: 92%

“…None of the patients enrolled in the study had serious side effects related to IVA. The INTUITION study [ 8 ] reported a series of 16 patients with idiopathic CNV. The treatment protocol included a loading dose of 3 IVA injections followed by a treat-and-extend (TER) regimen up to week 20.…”

Section: Discussionmentioning

confidence: 99%

“…Despite encouraging reports on the efficacy of IVA in choroidal neovascularization (CNV) secondary to pathologies other than nAMD, several aspects remain unexplained. While increased VEGF production is the common route on which different CNV-inciting pathologies converge, the response to anti-VEGF agents by CNV secondary to trauma, inflammation, and hereditary and degenerative disorders is not uniform and suggests that the VEGF load involved is largely modulated by the self-limited nature of the inciting pathology in contrast to the perpetual natural history of AMD [ 6 – 8 ]. Consequently, there is no consensus on the optimum initial dosing regimen and consecutive protocols for continuing treatment.…”

Section: Introductionmentioning

confidence: 99%

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A customized regimen of intravitreal aflibercept for the treatment of choroidal neovascularization secondary to different chorioretinal diseases

et al. 2023

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Background To assess the response of CNV secondary to chorioretinal diseases to IVA and to explore the adequate dosing regimen and the long-term results. Methods A retrospective study including patients with treatment-naïve active CNV secondary to chorioretinal diseases. All patients received an initial IVA injection followed by a PRN regimen. The main outcome measures were improvement of BCVA, improvement of anatomical morphology and vascularity of the CNV on SS-OCT, and SS-OCTA, respectively, and ocular or systemic complications attributed to IVA. Results The study included 17 eyes of 15 patients. Nine patients (60%) were females. The median age was 20 years. The main primary chorioretinal disease was vitelliform macular dystrophy (29%). The mean baseline BCVA was 0.16. The mean follow-up period was 15 months. Final BCVA improved by a mean of 6 lines. The CNV regressed or became inactive in all eyes. The median number of IVA injections was 2. There were no ocular or systemic complications attributed to IVA. Conclusion The customized IVA regimen is effective in inducing long-term regression of secondary CNV and in improving BCVA. Multimodal imaging is fundamental in establishing the diagnosis of CNV, and in monitoring its response to IVA.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A customized regimen of intravitreal aflibercept for the treatment of choroidal neovascularization secondary to different chorioretinal diseases

et al. 2023

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“…There were no reports of ocular serious adverse, and a few non‐ocular serious adverse events were reported, unrelated to the study drug or protocol. The safety profile of our study was in accordance with previously published studies (Heier et al, 2012; Ikuno et al, 2015; Kodjikian et al, 2022).…”

Section: Discussionsupporting

confidence: 91%

Efficacy and safety of Aflibercept for the treatment of inflammatory choroidal neovascularization: The ALINEA study

Kodjikian

Abukhashabah

Fardeau

et al. 2022

Acta Ophthalmologica

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Purpose To evaluate mean change in best‐corrected visual acuity (BCVA) at 52 weeks in patients with inflammatory choroidal neovascularization (CNV) treated with aflibercept. Methods We conducted a prospective non‐comparative open‐label trial. Following one mandatory intravitreal injection of aflibercept, patients were treated under a pro re nata (PRN) dosing regimen with monthly visits. Results A total of 19 patients were included, but one presented exclusion criteria; 16 patients were followed for the whole 52‐week study, and data for the primary endpoint analysis were available for 14. At baseline, mean BCVA and mean central retinal thickness (CRT) were 64.53 (±19.64) letters and 351.79 (±97.77) μm, respectively. At 52 weeks, the mean change in BCVA was +9.50 (±12.90) letters [95%CI = +2.05–+16.95]. One patient had lost more than 15‐letters at 24 weeks, and another one at 52 weeks. CRT change was −62.77 (±100.73) μm at 24 weeks and −66.53 (±97.47) μm at 52 weeks. There was a mean number of 3.56 (±3.29) intravitreal injections at 52 weeks (min = 1; max = 12). No serious ocular adverse events related to the treatment were reported. Conclusions Our study shows that aflibercept is clinically effective, both anatomically and functionally in the treatment of inflammatory CNV. Following the first injection, the PRN strategy appears sufficient for treating most choroidal neovessels.

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“…The earliest possible diagnosis of AMD and its neovascular complication allows for prompt treatment of the disease with intravitreal injections of anti-VEGF. Many studies have proved the efficacy and safety of bevacizumab, ranibizumab, and aflibercept in treating neovascular AMD [2,3,8] and other related diseases [9,10]. However, some differences in visual gain and anatomical outcomes exist between series, which appear to be associated with the baseline patient and disease characteristics and the treatment regimen used.…”

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confidence: 99%

Age-Related Macular Degeneration: New Insights in Diagnosis, Treatment, and Prevention

Mathis

Kodjikian

2022

JCM

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Efficacy and Safety of Aflibercept for the Treatment of Idiopathic Choroidal Neovascularization in Young Patients

Cited by 4 publications

References 38 publications

A customized regimen of intravitreal aflibercept for the treatment of choroidal neovascularization secondary to different chorioretinal diseases

A customized regimen of intravitreal aflibercept for the treatment of choroidal neovascularization secondary to different chorioretinal diseases

Efficacy and safety of Aflibercept for the treatment of inflammatory choroidal neovascularization: The ALINEA study

Age-Related Macular Degeneration: New Insights in Diagnosis, Treatment, and Prevention

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