Ophthalmology and therapy · 2026
Early Outcomes of Intravitreal Aflibercept 8 mg in Eyes Previously Treated with Aflibercept 2 mg for Neovascular Age-Related Macular Degeneration with AI-Based Biomarker Quantification.
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Bartolomeo Nicolò, Kalyvianakis Konstantinos Kitsos, Schuetz Yannic Pannatier, Nascimbeni Anna Chiara, Castro Daniela Gallo, Crozat Baptiste, Barry Mamadou Pathé, Ambresin Aude
Аннотация
INTRODUCTION: To evaluate the early outcomes of aflibercept 8 mg (afl8) treatment in patients with neovascular age-related macular degeneration (nAMD) previously treated with aflibercept 2 mg (afl2).
METHODS: A retrospective, observational, monocentric Swiss study. Patients with nAMD who had received ≥ 3 consecutive afl2 injections and switched to afl8 because of persistent or recurrent fluids, or to extend treatment intervals, were included in the study. All patients started a loading phase of 3-monthly afl8 injections, followed by a treat-and-extend regimen. Outcome measures included changes in best-corrected visual acuity (BCVA), maximal pigment epithelial detachment (PED) height, central subfield thickness (CST), optical coherence tomography (OCT) biomarkers quantified using artificial intelligence, and treatment intervals until month 6.
RESULTS: Fifty-two eyes of 44 patients who concluded the loading phase were included in this analysis. Mean age was 80.2 ± 8.5 years; 73% of patients were females. At month 6, BCVA was unchanged, PED and CST height experienced a significant decrease by - 18.5 ± 12.9 μm (p = 0.0005) and - 14.0 ± 3.5 μm (p = 0.0042), respectively. Volumes of intraretinal fluid (IRF), subretinal fluid (SRF), and PED decreased (IRF: 4.4 ± 15.6-3.8 nl; SRF: 15.7 ± 35.7-10.3 ± 34.0 nl; PED: 268.2 ± 423.2-252.2 ± 484.1 nl). Mean treatment intervals increased by 1.7 ± 0.5 weeks from the last assigned interval and by 0.6 ± 0.2 weeks from previous maximal fluid-free intervals after switching (p = 0.0005 and p = 0.18, respectively). One mild vitritis was observed and resolved with vitrectomy and topical drops without decreased visual acuity.
CONCLUSION: Our real-world study supports the potential short-term benefits of afl8 in improving anatomical and durability outcomes in patients with recurrent nAMD. These findings also highlight the added value of data-driven evaluations. Long-term studies are needed to confirm the effectiveness and durability of afl8 in this population.
METHODS: A retrospective, observational, monocentric Swiss study. Patients with nAMD who had received ≥ 3 consecutive afl2 injections and switched to afl8 because of persistent or recurrent fluids, or to extend treatment intervals, were included in the study. All patients started a loading phase of 3-monthly afl8 injections, followed by a treat-and-extend regimen. Outcome measures included changes in best-corrected visual acuity (BCVA), maximal pigment epithelial detachment (PED) height, central subfield thickness (CST), optical coherence tomography (OCT) biomarkers quantified using artificial intelligence, and treatment intervals until month 6.
RESULTS: Fifty-two eyes of 44 patients who concluded the loading phase were included in this analysis. Mean age was 80.2 ± 8.5 years; 73% of patients were females. At month 6, BCVA was unchanged, PED and CST height experienced a significant decrease by - 18.5 ± 12.9 μm (p = 0.0005) and - 14.0 ± 3.5 μm (p = 0.0042), respectively. Volumes of intraretinal fluid (IRF), subretinal fluid (SRF), and PED decreased (IRF: 4.4 ± 15.6-3.8 nl; SRF: 15.7 ± 35.7-10.3 ± 34.0 nl; PED: 268.2 ± 423.2-252.2 ± 484.1 nl). Mean treatment intervals increased by 1.7 ± 0.5 weeks from the last assigned interval and by 0.6 ± 0.2 weeks from previous maximal fluid-free intervals after switching (p = 0.0005 and p = 0.18, respectively). One mild vitritis was observed and resolved with vitrectomy and topical drops without decreased visual acuity.
CONCLUSION: Our real-world study supports the potential short-term benefits of afl8 in improving anatomical and durability outcomes in patients with recurrent nAMD. These findings also highlight the added value of data-driven evaluations. Long-term studies are needed to confirm the effectiveness and durability of afl8 in this population.