Improvement of the therapeutic effect in age-related macular degeneration after switching therapy from aflibercept to ranibizumab

Article Sidebar

PDF (Język Polski)


Published: Jun 30, 2017
DOI: https://doi.org/10.24292/01.ot.300617.03
Keywords:
age-related macular degeration, aflibercept, ranizbizumab

Main Article Content

Anna Hyjek-Ryś
Wojewódzki Szpital Okulistyczny w Krakowie
Maciej Kozak
Wojewódzki Szpital Okulistyczny w Krakowie
Ilona Pawlicka
Wojewódzki Szpital Okulistyczny w Krakowie
Grażyna Miklaszewska
Wojewódzki Szpital Okulistyczny w Krakowie

Abstract

The aim of the study: To evaluate anatomic and functional effects as well as the individual susceptibility to ranibizumab therapy in the absence of beneficial effects of aflibercept treatment in age-related macular degeneration.


Material and Method: Ten patients, unsuccessfully treated with intravitreal aflibercept injections, were qualified for the ranibizumab injection program in AMD treatment. Ineffective treatment was understood as an increase in macular edema, and the resultant increase in central retinal thickness, and increased leakage in fluorescein angiography with an accompanying decrease in visual acuity and progression of changes on the Amsler grid. Following the treatment with ranibizumab injections, the above mentioned parameters were subject to further control.


Results: Three patients experienced a reduction in central retinal thickness, edema and leakage area in fluorescein angiography, accompanied by reduced metamorphosis on the Amsler grid and stabilization or improvement of the best corrected visual acuity.


Conclusion: The conversion of aflibercept therapy to ranibizumab therapy may be valuable for patients with no effective treatment with aflibercept. The problem requires further follow-up and assessment. Final conclusions might help design better methods for individual patient selection.

Downloads

Download data is not yet available.

Article Details

How to Cite
1.
Hyjek-Ryś A, Kozak M, Pawlicka I, Miklaszewska G. Improvement of the therapeutic effect in age-related macular degeneration after switching therapy from aflibercept to ranibizumab. Ophthatherapy [Internet]. 2017Jun.30 [cited 2024Jul.3];4(2):85-1. Available from: https://journalsmededu.pl/index.php/ophthatherapy/article/view/563
Issue
Vol 4 No 2 (2017)
Section
Articles
Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Copyright: © Medical Education sp. z o.o. License allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.

Address reprint requests to: Medical Education, Marcin Kuźma (marcin.kuzma@mededu.pl)

References

1. Velez-Montoya R, Oliver SCN, Olson JL et al. Current knowledge and trends in age-related macular degeneration: genetics, epidemiology, and prevention. Retina. 2014; 34(3): 423-41.
2. Rosenfeld PJ, Brown DM, Heier JS et al; MARINA Study Group. Ranibizumab for neovascular age-related macular degeneration. N Engl J Med. 2006; 355(14): 1419-31.
3. ANCHOR Study Group. Ranibizumab versus verteporfin photodynamic therapy for neovascular age-related macular degeneration: two-year results of the ANCHOR study. Ophthalmology. 2009; 116(1): 57-65.
4. Miller JW, Le Couter J, Strauss EC et al. Vascular endothelial growth factor a in intraocular vascular disease. Ophthalmology. 2013; 120(1): 106-14.
5. Stewart MW, Rosenfeld PJ. Predicted biological activity of intravitreal VEGF Trap. Br J Ophthalmol. 2008; 92(5): 667-8.
6. Stewart MW. Aflibercept (VEGF trap-eye) for the treatment of exudative age-related macular degeneration. Expert Rev Clin Pharmacol. 2013; 6(2): 103-13.
7. Forooghian F, Cukras C, Meyerle CB et al. Tachyphylaxis after intravitreal bevacizumab for exudative age related macular degeneration. Retina. 2009; 29(6): 723-31.
8. Nudleman E, Wolfe J, Woodward M et al. Worsening anatomic outcomes following aflibercept for neovascular age-related macular degeneration in eyes previously well controlled with ranibizumab. Clin Ophtalmol. 2016; 10: 1053-7 (erratum: Clin Ophtalmol. 2017; 11: 355).
9. Singh RP, Srivastava SK, Ehlers JP et al. A single-arm, investigator-initiated study of the efficacy, safety, and tolerability of intravitreal aflibercept injection in subjects with exudative age-related macular degeneration previously treated with ranibizumab or bevacizumab (ASSESS study): 12-month analysis. Clin Ophthalmol. 2015; 9: 1759-66 (erratum: Clin Ophthalmol. 2017; 11: 303).
10. Bakall B, Folk JC, Boldt HC et al. Aflibercept therapy for exudative age-related macular degeneration resistant to bevacizumab and ranibizumab. Am J Ophthalmol. 2013; 156(1): 15-22.
11. Yonekawa Y, Andreoli C, Miller JB et al. Conversion to aflibercept for chronic refractory or recurrent neovascular age-related macular degeneration. Am J Ophthalmol. 2013; 156(1): 29-35.
12. Ho VY, Yeh S, Olsen TW et al. Short-term outcomes of aflibercept for neovascular age-related macular degeneration in eyes previously treated with other vascular endothelial growth factor inhibitors. Am J Ophthalmol. 2013; 156(1): 23-8.e2.
13. Cho H, Shah CP, Weber M et al. Aflibercept for exudative AMD with persistent fluid on ranibizumab and/or bevacizumab. Br J Ophthalmol. 2013; 97(8): 1032-5.
14. Kumar N, Marsiglia M, Mrejen S et al. Visual and anatomical outcomes of intravitreal aflibercept in eyes with persistent subfoveal fluid despite previous treatments with ranibizumab in patients with neovascular age-related macular degeneration. Retina. 2013; 33(8): 1605-12.
15. Abedi F, Wickremasinghe S, Richardson AJ et al. Variants in the VEGFA gene and treatment outcome after anti-VEGF treatment for neovascular age-related macular degeneration. Ophthalmology. 2013; 120(1): 115-21.