Efficacy of Aflibercept as initial treatment for neovascular age-related macular degeneration in an Iraqi patient sample

J Med Life. 2023 Feb;16(2):235-243. doi: 10.25122/jml-2022-0356.

Abstract

Age-related macular degeneration (AMD) is a progressive degenerative eye disorder that primarily affects individuals over 50. It causes gradual loss of central vision and can lead to irreversible severe visual loss if left untreated. AMD is a leading cause of blindness in the developed world. This study aimed to investigate the effects of a loading dosage of intravitreal Aflibercept on functional and morphological responses in neovascular AMD, considering demographic characteristics and the link between AMD-related retinal symptoms at presentations. A prospective interventional study was conducted from November 2021 to September 2022 on a sample of Iraqi patients with neovascular AMD who had active choroidal neovascularization (CNV) lesions confirmed by OCT-A and received intravitreal Aflibercept 2mg injection as initial therapy (3 loading doses). Best-corrected visual acuity (BCVA) was used to measure functional responses, and central macular thickness (CMT) and maximum area of the retinal thickness (MART) (by SD-OCT) were used to measure morphological responses. The study included 48 patients (57 eyes) with active neovascular AMD. The mean difference of BCVA in log MAR (0.2 ± 0.7) significantly improved from 1.3±0.7 at baseline to 1.1±0.8 after loading Aflibercept (P=0.034). The mean difference in CMT 113.6 ± 125.9 was statistically significant (P<0.0001). Also, the mean change in MART significantly decreased from 444.2 ± 127.1 µm at baseline to 348.7±74.5 µm (p < 0.0001) after loading Aflibercept. This study demonstrated that Aflibercept is a functionally and anatomically successful treatment for neovascular AMD.

Keywords: Aflibercept; anti-VEGF; neovascular age-related macular degeneration (AMD); prospective study; vascular endothelial growth factor (VEGF).

MeSH terms

  • Angiogenesis Inhibitors* / therapeutic use
  • Follow-Up Studies
  • Humans
  • Intravitreal Injections
  • Iraq
  • Prospective Studies
  • Tomography, Optical Coherence
  • Treatment Outcome
  • Vascular Endothelial Growth Factor A
  • Visual Acuity
  • Wet Macular Degeneration* / diagnostic imaging
  • Wet Macular Degeneration* / drug therapy

Substances

  • aflibercept
  • Angiogenesis Inhibitors
  • Vascular Endothelial Growth Factor A