Early real-world outcomes of aflibercept 8 mg in previously treated neovascular age-related macular degeneration.

BACKGROUND: Real-world evidence of aflibercept 8 mg in treatment-experienced patients remains limited. This study evaluated early outcomes of switching treatment-refractory patients with neovascular age-related macular degeneration (nAMD) to aflibercept 8 mg.

METHODS: This retrospective cohort study analysed previously-treated patients who switched to aflibercept 8 mg between January and June 2025. Best-corrected visual acuity (BCVA), central macular thickness (CMT), pigment epithelial detachment (PED) height, macular fluid status and treatment intervals were evaluated at baseline, 3 months, 6 months and final visit.

RESULTS: 58 patients (66 eyes) were included. Patients received a mean 24.98 ± 18.04 anti-VEGF injections per eye over 49.41 ± 35.74 months pre-switch. Mean 5.15 ± 1.51 aflibercept 8 mg injections were administered per eye over a mean follow-up period of 25.86 ± 8.34 weeks. Median treatment intervals increased significantly from baseline to final visit (4 to 6 weeks, p < 0.001). 23 eyes (34.8%) achieved ≥8-week intervals by final follow-up. Median BCVA remained stable (70 ETDRS letters, interquartile range [IQR] 62-76 baseline and final follow-up, p = 0.571), as did median CMT (230.5 μm (IQR 189.5-281.2) at baseline to 226.5 μm (IQR 195-257) at final follow-up, p = 0.494). Median PED height showed a significant reduction (175 μm (IQR 106-287) at baseline to 173 μm (IQR 105-251) at final follow-up, p = 0.045). Complete macular fluid resolution occurred in 23.9% of eyes with baseline fluid at the final visit. No serious ocular adverse events occurred in this cohort.

DISCUSSION: Aflibercept 8 mg demonstrated modest interval extension with stable functional and anatomical outcomes in heavily pre-treated nAMD patients. Long-term studies are needed to establish durability.