In:
Retina, Ovid Technologies (Wolters Kluwer Health), Vol. 39, No. 2 ( 2019-02), p. 303-313
Abstract:
To investigate the outcomes of intravitreal aflibercept in refractory pigment epithelial detachment (PED) with or without subretinal fluid (SRF) in patients with neovascular age-related macular degeneration. Methods: A prospective, nonrandomized, interventional case series involved 40 patients with persistent vascularized PED previously treated with at least 3 injections of intravitreal bevacizumab or ranibizumab. Intravitreal aflibercept was administered as 3 initial loading doses every 4 weeks, followed by pro re nata retreatment every 8 weeks over 48 weeks. Pigment epithelial detachment was classified into solid-, hollow-, or mixed-type according to the reflective properties visualized using optical coherence tomography. The mean changes in best-corrected visual acuity, central subfield thickness, and the volumes of SRF and PED were analyzed. Results: The PED volume (baseline: 0.43 ± 0.55 mm 3 ) significantly reduced to 0.23 ± 0.32 mm 3 at Week 8 ( P = 0.003) and increased to 0.36 ± 0.41 mm 3 at Week 48 ( P = 0.345). The SRF volume (baseline: 0.52 ± 0.64 mm 3 ) significantly reduced to 0.24 ± 0.43 mm 3 at Week 48 ( P = 0.021). The mean baseline best-corrected visual acuity was 20/75 (47.5 letters); it showed no significant difference at Week 48 (+4.4 letters; P = 0.125). The baseline central subfield thickness was 323.2 ± 92.3 μ m; it significantly reduced to 281.2 ± 90.7 μ m at Week 48 ( P = 0.001). In solid-type PEDs, there were poorer improvements in central subfield thickness, best-corrected visual acuity, and the volumes of the SRF and PED, with newly developed intraretinal cysts. Conclusion: Intravitreal aflibercept in treatment-resistant neovascular age-related macular degeneration led to significant reduction in PED and SRF volume, central subfield thickness, and best-corrected visual acuity preserved, over 12 months. However, solid-type PED showed less improvement than hollow- or mixed-type PED.
Type of Medium:
Online Resource
ISSN:
0275-004X
DOI:
10.1097/IAE.0000000000001947
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2019
detail.hit.zdb_id:
2071014-8
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