Initial Functional and Anatomical Outcomes of High-dose Aflibercept 8 mg in Exudative Neovascular Age-related Macular Degeneration

• DOI: 10.1016/j.oret.2025.02.002
• Publication Date: 2025-02-08T00:13:11Z
• Authors: Suraj Bala; Gabriel C.S. Barbosa; Nitesh Mohan; Sunil K. Srivastava; Peter K. Kaiser; Ananth Sastry; Amy S. Babiuch; Jonathan Sears; Katherine E. Talcott; Alex Yuan; Aleksandra Rachit...; Justis P. Ehlers; Andrew P. Schachat; Phoebe Lin; Sumit Sharma; Danny A. Mammo
• Keywords: Aflibercept

To evaluate the short-term outcomes of patients with exudative neovascular age-related macular degeneration (nAMD) treated high-dose aflibercept 8.0 mg (HDA), focusing on anatomical and functional changes, as well feasibility extending treatment intervals in real-world clinical practice. Retrospective, noncomparative cohort study. 219 eyes from 184 nAMD who received at least three HDAs between August 2023 October 2024. Patients included this study were either treatment-naïve or had been previously other anti-VEGF agents. Clinical outcomes, including best-corrected visual acuity (BCVA) OCT parameters, evaluated baseline after each HDA. The primary outcome was proportion able to sustain an 8 ± 1 week longer interval without deterioration. Secondary changes. average follow-up time 22.9 4.9 weeks. 209 (95.4%) treated, 10 (4.6%) treatment-naïve. After first injections, 206 (94.1%) a fourth HDA 70 (31.9%) fifth 102 (46.6%) total shorter than weeks initial injections persistent fluid. 24 (11.0%) switched another agent. Overall, mean BCVA 61.9 21.7 ETDRS letters 61.7 22.6 final visit, no statistically significant difference observed (p = 0.934). Central subfield thickness pigment epithelial detachment height remained stable. Significant reductions subretinal (54.3% 41.1%, p 0.006) intraretinal fluid (53.9% 39.3%, 0.002). Among eyes, pre-switch 5.8 2.5 increased 7.4 2.2 < 0.0001). demonstrated stable during period. A considerable unable extend 8-weeks due These findings suggest that maintains stability while improving anatomic though challenges managing chronic may limit ability intervals.