J Korean Ophthalmol Soc.  2022 Jun;63(6):526-534. 10.3341/jkos.2022.63.6.526.

Outcome of Aflibercept-Bevacizumab Alternate Dosing in Neovascular Age-related Macular Degeneration with Limited Response to Aflibercept

• Shin D
• Kim JH

• KMID: 2530552
• DOI: http://doi.org/10.3341/jkos.2022.63.6.526

Abstract

Purpose
To investigate the efficacy of aflibercept-bevacizumab alternate dosing (AD) in neovascular age-related macular degeneration (AMD) with a limited response to bimonthly aflibercept injections.
Methods
This retrospective study included patients given aflibercept-bevacizumab AD to treat neovascular AMD with bevacizumab given every alternate month between bimonthly aflibercept injections when they had a limited response to bimonthly aflibercept alone. The best-corrected visual acuity (BCVA) and central retinal thickness (CRT) were compared before AD and after the last AD. The incidence of subretinal fluid (SRF) and intraretinal fluid (IRF) before and after AD was also examined.
Results
The study included 18 patients. The mean period between the diagnosis and AD was 37.9 ± 18.8 months and a mean of 3.1 ± 2.2 ADs were performed. The BCVA improved significantly from 0.45 ± 0.28 before AD to 0.36 ± 0.23 after AD (p = 0.036). The CRT decreased significantly from 440.3 ± 122.9 μm before AD to 317.7 ± 103.5 after AD (p = 0.001). The SRF was present in 94.4% and IRF in 55.6% before AD and in 22.2% and 11.1%, respectively, after AD.
Conclusions
Aflibercept–bevacizumab AD was effective at resolving SRF/IRF in neovascular AMD with a limited response to bimonthly aflibercept injections and should be a useful treatment option.

Keyword

Aflibercept, Age-related macular degeneration, Bevacizumab, Choroidal neovascularization