SYSTEMIC ANTI-VEGF BIOSIMILAR THERAPY ASSOCIATED WITH IMPROVED MACULAR ANATOMY AND DURATION OF EFFECT IN A PATIENT WITH NEARLY RECALCITRANT NEOVASCULAR AGE-RELATED MACULAR DEGENERATION.

PURPOSE: To present a patient with neovascular AMD treated systemically with the biosimilar bevacizumab-awwb (Mvasi) with superior subretinal fluid resolution when compared with continuous and repeated intravitreal treatments.

METHODS: Retrospective single case report.

RESULTS: After 3 years of monthly aflibercept treatment for nAMD, the patient had persistent subretinal fluid. Systemic bevacizumab-awwb (Mvasi) infusions were initiated by her oncologist for ovarian cancer, and subretinal fluid resolved for the first time. After one additional aflibercept injection and continued bevacizubam-awwb infusions for her cancer, subretinal fluid did not recur. Thirteen weeks later, at the final follow-up before the patient passed away, the macula remained dry and no additional intravitreal treatment was given.

CONCLUSION: When systemic anti-VEGF biosimilar therapy was administered, there was improved anatomy and prolonged duration of effect compared with the intravitreal therapy alone. Adverse systemic effects limit the routine use of systemic anti-VEGF therapy for retinal disease. However, if a patient requires systemic anti-VEGF or anti-VEGF biosimilar therapy for malignancy, it may also benefit retinal disease leading to benefits in quality of life and fewer office visits.