The results of aflibercept therapy as a first line treatment of age-related macular degeneration.

PURPOSE: To report the results of aflibercept treatment in treatment-naive neovascular age-related macular degeneration (AMD) patients and suggest a suitable treatment algorithm for routine clinical practice. METHOD: The medical charts of patients treated with intravitreal aflibercept for neovascular AMD were reviewed retrospectively. Best corrected visual acuity, slit-lamp examination, dilated fundus examination, applanation tonometry, and a total number of aflibercept injections were recorded. Aflibercept therapy was applied in an as-needed algorithm after three monthly loading dose. Additionally, optic coherence tomography data, including presence or absence of macular fluid and central macular thickness were recorded. RESULTS: Thirty-eight eyes of 36 patients were included in this study. The mean number of aflibercept injections was 4.86 ± 2.76 (3-18). Mean follow-up time was 12.1 ± 5.7 months (6-26). Thirty-seven eyes (97.3%) achieved maintenance of vision. The mean best corrected visual acuity (logMAR) increased from 0.98 ± 0.56 (0.2-2.4) to 0.57 ± 0.31 (0.1-1.3), (P = 0.001). Mean visual acuity gain was 15.86 ± 12.18 letters at the end of the study. The mean central macular thickness decreased from 327.9 ± 56.5 µm (219-474 µm) to 277.0 ± 53.0 µm (197-405 µm), (P = 0.016). CONCLUSIONS: Aflibercept therapy appears to be a safe and effective treatment for neovascular AMD. Injections applied in an as-needed algorithm after three monthly loading doses were successful to maintain and improve visual acuity.

Aflibercept: an update on recent milestones achieved.

In the last decade, intravitreal medications targeted to vascular endothelial growth factor (VEGF) such as pegaptanib, ranibizumab and bevacizumab have revolutionized the treatment and significantly improved visual acuity outcomes in patients with retinal vascular diseases such as age-related macular degeneration (AMD), diabetic macula edema (DME) and retinal vein occlusion (RVO). In recent years, aflibercept, an anti-VEGF drug that targets all isoforms of VEGF as well as placenta growth factor, has shown similar effectiveness in recent clinical trials. Aflibercept has firmly joined ranibizumab and bevacizu-mab as an important therapeutic option in the management of neovascular AMD. More recently, aflibercept appears to be contending with ranibizumab and bevacizumab as an important therapeutic option in the management of DME and RVO.