Real-life outcomes in patients with neovascular age-related macular degeneration switched from ranibizumab to aflibercept

Background: To report the short term real-life outcomes of neovascular age-related macular degeneration (nAMD) patients switched to intravitreal aflibercept after failure to prior ranibizumab treatment.Methods: Thirty eyes of thirty refractory nAMD patients with previously treated with intravitreal ranibizumab, that switched to intravitreal aflibercept injections were enrolled.The best corrected visual acuity (BCVA) measurements and spectral domain optical coherence tomography (SD OCT) characteristics over time were evaluated.Results: The mean age of the patients was 73.76 ± 6.75 years (range 58-88 years).The mean central macular thickness (CMT) decreased from 319.7 ± 85.2µm at baseline to 261.7 ± 74.3µm at 12th week.This reduction was found to be statistically significant (p<0.001).After 12 weeks treatment period, the number of patients that presented with intraretinal fluid (IRF) decreased from 19 (63.3%) to 10 (33.3%).This improvement was found to be statistically significant (p<0.001).By the same treatment period 24 patients (80%) with high reflective foci (HRF) was reduced to 12 patients (40%) (p<0.001).The mean BCVA improved from 1.0±0.75logMAR at baseline to 0.91 ± 0.75; however this change was not statistically signficant (p:0.097).Conclusion: Switching to aflibercept resulted in a better anatomic response and visual stabilization in patients with nAMD resistant to ranibizumab treatment.