Aflibercept provides effective alternative to intravitreal ranibizumab

Aflibercept induces a favourable short-term response among pachychoroid neovasculopathy (PNV) patients who do not respond to intravitreal ranibizumab, a recent study has found.

Fourteen eyes of 14 patients (mean age, 64.1±7.5 years; 50 percent male) with PNV were included in the study. Only those with inadequate responses to at least three injections of ranibizumab―and switched to aflibercept―were eligible. The primary outcome measure was the percentage of eyes with dry macula 4 weeks after the last aflibercept injection.

At baseline, all eyes had subretinal fluid, which remained throughout every visit while participants were under ranibizumab treatment.

However, after the third aflibercept injection, more than half of the eyes (57.1 percent; n=8) achieved dry macula status without serous pigment epithelium detachment or subretinal or intraretinal fluid. It took an average of 1.7±0.9 aflibercept injections before complete fluid resolution in these eyes.

One eye achieved dry macula status after the first aflibercept injections, though developed recurrent subretinal fluid after the second and third administrations.

In terms of the secondary outcomes, subretinal fluid thickness decreased significantly after three aflibercept injections (102±48 to 39±62 µm; p=0.0009). A similar nominal decrease was observed during the ranibizumab treatment period, though statistical significance was not achieved (p=0.084).

Aflibercept was also safe and did not lead to any serious adverse events, such as retinal detachment and macular haemorrhage, during the study period.