AFL in real-world

This video summarises the 2-year real-world study of intravitreal aflibercept for the treatment of naive neovascular age related macular degeneration that was presented at this year’s EURETINA congress held in Copenhagen, Denmark (Friday 9 September 2016, 16:30-18:00). This was a prospective, non-randomized, single centre review of 53 consecutive treatment-naive eyes of 49 patients with exudative AMD on a regime of 3 monthly loading, then 8 weekly intravitreal injections of aflibercept in Year 1 and individualized treatment in Year 2. Follow-up examinations were scheduled at 4, 6, 12 and finally, 24 months. Investigators reported that 27 eyes completed 2-year follow up, 68% of who had occult nAMD lesions. Mean letter gain was +5.4 at 12 months (n=38) and +8 at 24 months (n=26). 95% and 96% of treated patients maintained stable vision (lost fewer than 15 letters) at 12 and 24 months, respectively. 45% vs. 50% had no fluid detected on their OCT at 12 and 24 months, respectively. In Year 1, the mean number of injections was 8. In Year 2, an individualized treatment protocol was adopted; the average number of injections was 4. Fewer visual acuity gains and a greater proportion of retinas with fluid as shown by an OCT can be seen in Year 1 with fixed dosing compared with Year 2 where fewer number of injections were given. The study supports that an individualized treatment plan in Year 2 can maintain visual gains and anatomical improvement in nAMD patients treated with intravitreal aflibercept.