Aflibercept in refractory wet AMD treated with ranibizumab: Anatomical and visual outcome

PURPOSE: To assess the anatomical outcome of patients with exudative age-related macular degeneration resistant to ranibizumab treated with aflibercept. METHOD: Prospective, interventional, case series, where we treated a group of patients deemed resistant to Ranibizumab after 6 months of persistence of intra- or subretinal fluid despite continuous treatment. RESULTS: The study included 17 patients, 3 males and 14 females. The average males age was 85 (range 83–87), and that of females was 79.64 (range 68–88). At the start of the study, the central foveal thickness CFT average was 534.76 μm (range 252–999). At 1 month and after 1 injection of Aflibercept, the CFT average was 324.82 μm (range 222–585). At 4 months and after 3 consecutive injections of Aflibercept the CFT average was 294.76 μm (range 184–640). At 6 months the CFT average was 356 μm (range 206–609). At the 5th visit only 8 out 17 (47%) patients required repeated injection either for persistent fluids or for recurrence. At the 6th and final visit only 4 out of 17 (23.5%) needed repeated injections, of them only one was treated on the visit before and treatment was given as very little response was observed from last injection, and all other 3 were not treated on the visit before. CONCLUSION: Our results showed that aflibercept was able to dry the macula even in advanced case of wet AMD resistant to Ranibizumab.