One-year outcomes of fixed treatment of intravitreal aflibercept for exudative age-related macular degeneration and the factor of visual prognosis

Abstract

The aim of this study was to investigate the efficacy of periodic intravitreal aflibercept (IVA) in exudative age-related macular degeneration, and to explore the predictive factors for visual outcome.This is a prospective interventional case series.Fifty-two eyes of 52 treatment-naïve age-related-macula-degeneration patients were enrolled. All participants received IVA bimonthly following 3 monthly loading dose. The primary endpoint was change in best corrected visual acuity (BCVA) and central retinal thickness (CRT), and the secondary outcomes included changes in subfoveal choroidal thickness (SCT), macular atrophy (MA), and retinal average sensitivity (AS) determined by microperimetry at 12 months compared with baseline. The predictive factors for the change of BCVA were examined.Of 52 enrolled patients, 4 patients were drop out. Remaining 48 patients were examined. Mean logMAR BCVA significantly improved from 0.42 ± 0.37 at baseline to 0.29 ± 0.34 at 12 months (P = .008). Mean CRT and SCT significant reduced from 285.6 ± 135.2 μm, 247.9 ± 96.7 μm at baseline to 233.4 ± 98.0 μm, 208.1 ± 94.6 μm at 12 months, respectively (P < .001). At 12 months, 35 eyes of 48 eyes (72.3%) were archived dry macula. MA occurred in 7 eyes of 35 eyes with dry macula at 12 months (20.0%). AS was significant improved (P = .027) between baseline (median: 15.7 dB) and 12 months (median: 19.5 dB). The BCVA of the cases with MA involved fovea was significant worse. Age was significantly predicted for the BCVA at 12 months.IVA administered over 1 year improved BCVA, AS, and morphological findings, and the predictive factors for BCVA were age and MA-involved fovea.

Improvements of Retinal Sensitivity after Intravitreal Injection of Aflibercept in Eyes with Neovascular Age-Related Macular Degeneration with or without Polypoidal Choroidal Vasculopathy

“…This agrees with other studies where the authors showed that the MS measured by MP improved up to 6 or 12 months during aflibercept therapy. Ono et al [35] reported that the BCVA was significantly improved at 3, 6, and 12 months relative to the baseline after IVA, which is similar to our findings. Moreover, the changes in the retinal sensitivity in a 10° macular area measured by MAIA perimetry were significantly improved at 12 months relative to the baseline but not at 6 months.…”

“…Because of these features, the application of MP in clinical studies has provided important diagnostic and prognostic information on the functional macular changes in AMD patients [27]. The information collected by MP in the functional assessment of nAMD is helpful, and it can quantify the severity of the functional depression at various stages of AMD [28,29], investigate the relationship between the retinal sensitivity and the retinal morphology [30,31], and determine the efficacy of anti-VEGF agents (bevacizumab [32], ranibizumab [33], and aflibercept [34][35][36]). However, the studies that have reported the changes in retinal sensitivity in patients with nAMD during aflibercept treatments are limited.…”

“…In addition, the studies were performed on different subtypes of AMD and under different study conditions such as the equipment used and areas of the macula studied. These differences have made it difficult to determine the true effectiveness of the treatments [35,36]. Therefore, further research is needed with a test that will assess retinal sensitivity in patients with nAMD.…”