Résultats anatomiques précoces des injections intravitréennes d'aflibercept 8 mg chez les patients atteints de dégénérescence maculaire liée à l'âge néovasculaire récidivante
Aude AMBRESIN (Lausanne, Suisse), Yannic Pannatier (Lausanne, Suisse), Anna Chiara Nascimbeni (Lausanne, Suisse), Daniela Gallo Castro (Lausanne, Suisse), Mamadou Pathé Barry (Lausanne, Suisse), Nicolo Bartolomeo (Lausanne, Suisse)
Introduction

We aim to report the early anatomical outcomes of aflibercept 8 mg (IVA) treatment in neovascular age-related macular degeneration (nAMD) patients previously treated with aflibercept 2mg.

Matériels et Méthodes

Patients diagnosed with an active submacular neovascularization (MNV) secondary to AMD and who received at least 3 consecutive injections of aflibercept 2mg were included in the study. Patients were started on a loading phase of three-monthly IVA. Monthly SD-OCT and ophthalmic fundoscopy were performed at each visit. Outcomes measures include maximal pigment epithelial detachment height, central subfield thickness (CST), presence or absence of intraretinal fluid (IRF) and subretinal fluid (SRF) on SD-OCT, and mean volumetric changes in IRF, SFR, and PED using AI at baseline, month 1, 2, and 3.

Résultats

29 eyes of 25 switch nAMD patients receiving IVA that completed the loading phase were included in the study. Mean age at baseline was 81.10 ± 8.01 years, 19 patients (76%) were female. At baseline, mean CST was 261.2 ± 67.53μm, mean baseline maximal PED height was 174.9 ± 94.91 μm. At month 3, after the loading phase, mean CST significantly decreased of -25.6μm, and maximal PED height significantly decreased of -40.6μm. 90% and 83% of eyes had a complete reabsorption of IRF and SRF at month 3, respectively. After the loading phase, IRF, SRF and PED volumes significantly decreased from 2nL to 0nL, 29nL to 6nL, and 237nL to 187nL, respectively. No intraocular inflammations were reported during the loading phase.

Discussion

Aflibercept 8mg treatment in previously-treated nAMD patients leads to a prompt amelioration of anatomical outcomes. These findings demonstrate that the higher dosage of the molecule seems to be a valuable alternative to aflibercept 2mg as it offers significant drying effects. A comprehensive analysis of follow up visits will be performed to assess durability outcomes.

Conclusion

Aflibercept 8mg intravitreal injections in the treatment of patients with recurrent nAMD demonstrated rapid and significant improvement of anatomical parameters, particularly regarding qualitative and quantitative biomarkers on OCT, including CST and PED height.