Results of Switch from Intravitreal Aflibercept to Ranibizumab in Patients with Exudative Age-related Macular Degeneration – Own Experience
Wydanie specjalne czerwiec 2018
str. 11 – 15
Autorzy: Anna Michalska, Martyna Piotrowska, Paweł Stala
Oddział Okulistyki WSS Nr 2 w Jastrzębiu-Zdroju
Kierownik: dr n. med. Paweł Stala
Aim: To evaluate effectiveness of the switch to ranibizumab in patients with neovascular age-related macular degeneration who do not respond to primary therapy of aflibercept.
Material and Methods: 20 patients (20 eyes) with exudative age-related macular degeneration treated with intravirteous aflibercept injections within the treatment program. The treated group of patients fulfilled the criteria of tachyphylaxis or poor or non-respond to primary treatment with intravitreous injections after over a year period of time. In treatment of those patients ranibizumab replaced aflibercept. Best corrected visual acuity and the mean central retinal thickness in macula were evaluated. The examinations were performed before the first aflibercept injection, after the third, seventh, and before the first ranibizumab injection, after 1, 2, 3. Central retinal thickness evaluated with optical coherence tomography (3D OCT 2000 Topcon).
Results: Statistical analysis did not reveal the significant differences of best corrected visual acuity and central retinal thickness after the change of medicine during the observation period. However, while analysing separately individual cases, morphological improvement of central retinal thickness (decrease of its thickness) together with impeded activity of choroidal neovascularization were observed in part of the patients.
Conclusions: In exudative age-related macular degeneration therapy switching from aflibercept to ranibizumab might be beneficial for some patients primarily poorly or non-responding to treatment with aflibercept and with observed tachyphylaxis. Replacing medicine in exudative therapy needs further multi-centre randomized researches, mainly regarding the most suitable moment for changing therapy.