VISUAL FINDINGS IN NEOVASCULAR MACULAR DEGENERATION REFRACTORY TO BEVACIZUMAB AFTER INTRAVITREAL AFLIBERCEPT THERAPY

Dr. Carmel M. Moazez MD*, Kasra Rezaei MD, Clive H. Sell MD, Rahul Reddy MD

ABSTRACT

Neovascular (wet) age-related macular degeneration (AMD) is associated with blindness in patient populations above 55 years of age, affecting approximately 2 million Americans. Intravitreal (IV) bevacizumab is widely employed in the treatment of wet AMD. Development of a novel pharmacologic intervention to match bevacizumab’s indications is possible with the advent of aflibercept. This study evaluated the optical coherence tomographic (OCT) findings and intraocular pressure after IV aflibercept therapy in patients with wet AMD refractory to IV bevacizumab therapy. This retrospective review of 29 patient records (30 eyes) demonstrated that 73% of patients did not show an increase in OCT. Furthermore, 83% of patients did not demonstrate an increase in intraocular pressure (IOP) and all patients had an IOP of 20 or less after three months of therapy. This study further explores the mean change per patient in retinal thickness via OCT as well as intraocular pressure. The results of this study demonstrate that aflibercept can improve visual findings in patients refractory to bevacizumab and therefore we recommend that patients be switched to it. Further, it is safe to use in patients with glaucoma as it will not increase the IOP.

Keywords: aflibercept, age-related macular degeneration.