Treat-and-extend approach with aflibercept: Effects on different subtypes of age-related choroidal neovascularisation

• Published in: Archivos de la Sociedad Española de Oftalmología (English ed.) 2017-03, Vol.92 (3), p.112-119
• Main Authors: Castro-Navarro, V, Cervera-Taulet, E, Montero-Hernández, J, Navarro-Palop, C
• Format: Article
• Language: English
• Subjects: Aflibercept; Choroidal neovascularisation; Choroidal thickness; Grosor coroideo; Neovascularización coroidea; Ophthalmology; Proliferación angiomatosa retiniana; Retinal angiomatous proliferation; Spectral-domain optical coherence tomography; Tomografía de coherencia óptica de dominio espectral; Tratar y extender; Treat and extend
• ISSN: 2173-5794; 2173-5794
• DOI: 10.1016/j.oftale.2016.09.018

Abstract Objective To describe functional/morphological outcomes of treat-and-extend (TAE) with aflibercept in different subtypes of neovascularizations (CNV) secondary to exudative age-related macular degeneration (AMD). Methods Retrospective study was conducted on 30 eyes of 30 patients treated with 2 mg-aflibercept according to a TAE protocol. Examinations included best corrected visual acuity (BCVA), number of injections, and visits needed. A quantitative/qualitative analysis was also performed with fluorescein angiography and spectral-domain optical coherence tomography (SD-OCT) at baseline, and at 3, 6, and 12 months. Results BCVA significantly improved from 0.61 ± 0.26 logMAR to 0.38 ± 0.34 logMAR. Among the total AMD patients, type 1 CNV was diagnosed in 11 eyes (36%), type 2 CNV in 7 eyes (23%), mixed CNV in 5 eyes (16%), and type 3 CNV or retinal angiomatous proliferation (RAP) in 7 eyes (23%). The final mean number of injections was 7.5 ± 1.65, 8.71 ± 0.76, 7.4 ± 0.89, 7.2 ± 0.7, and number of visits 6.6 ± 2.17, 7.89 ± 1.46, 5.8 ± 1.7, and 7.14 ± 1.57, respectively in type 1, type 2, mixed, and type 3 or RAP. There was no difference between the different subtypes of CNV ( P > 0.05). Conclusions Aflibercept in TAE is effective for all exudative-AMD subtypes. No significant differences in patient's visual gain, mean number of injections, or number of visits needed were found among the subtypes of CNV.