One-year result of aflibercept treatment on age-related macular degeneration and predictive factors for visual outcome.

Abstract

PURPOSE:

To investigate the efficacy of periodic injection of aflibercept in each subtype of age-related macular degeneration (AMD) and to explore the predictive factors for visual outcome in clinical settings.

DESIGN:

Prospective nonrandomized interventional case series.

METHODS:

Patients with AMD were recruited and were administered aflibercept injections once a month for 3 months followed by once every 2 months for 8 months. The logarithm of the minimal angle of resolution (logMAR) at 12 months and improvement of vision from baseline were compared among polypoidal choroidal vasculopathy (PCV), retinal angiomatous proliferation (RAP), and typical AMD. Regression rate of polypoidal lesions was assessed. We also performed regression analysis with logMAR at 12 months as the dependent variable.

RESULTS:

The study sample consisted of 98 patients: 46 had typical AMD, 42 had PCV, and 10 had RAP. Mean logMAR improved from 0.36 to 0.21 in 12 months. While there was no difference in visual improvement between typical AMD and PCV, final logMAR was better in PCV (0.32 ± 0.09 vs 0.08 ± 0.04, P = .016). Thirty-nine PCV patients underwent follow-up angiography, and regression of polyps was observed in 27 cases (69.2%). Multiple regression analysis showed that the presence of external limiting membrane (ELM), smaller greatest linear dimension, and the presence of polypoidal lesion were associated with better visual outcome (R(2) = 0.53, P = 2.73 × 10(-14)).

CONCLUSIONS:

Periodic injection of aflibercept is effective for PCV as well as for typical AMD. The statuses of ELM, greatest linear dimension, and polypoidal lesion are predictive for visual outcome.

• Authors: Akio Oishi, Akitaka Tsujikawa, Kenji Yamashiro, Sotaro Ooto, Hiroshi Tamura, Hideo Nakanishi, Naoko Ueda-Arakawa, Masahiro Miyake, Yumiko Akagi-Kurashige, Masayuki Hata, Munemitsu Yoshikawa, Yoshimasa Kuroda, Ayako Takahashi, Nagahisa Yoshimura
• Journal: American journal of ophthalmology (Am J Ophthalmol) Vol. 159 Issue 5 Pg. 853-60.e1 (May 2015) ISSN: 1879-1891 [Electronic] United States
• PMID: 25634529 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2015 Elsevier Inc. All rights reserved.

Chemical References

• Angiogenesis Inhibitors
• Recombinant Fusion Proteins
• VEGFA protein, human
• Vascular Endothelial Growth Factor A
• aflibercept
• Receptors, Vascular Endothelial Growth Factor

Topics

• Aged
• Angiogenesis Inhibitors (therapeutic use)
• Female
• Fluorescein Angiography
• Follow-Up Studies
• Humans
• Intravitreal Injections
• Macular Degeneration (diagnosis, drug therapy, physiopathology)
• Male
• Prospective Studies
• Receptors, Vascular Endothelial Growth Factor (therapeutic use)
• Recombinant Fusion Proteins (therapeutic use)
• Refraction, Ocular (physiology)
• Tomography, Optical Coherence
• Treatment Outcome
• Vascular Endothelial Growth Factor A (antagonists & inhibitors)
• Visual Acuity (physiology)