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RANIBIZUMAB AND AFLIBERCEPT FOR THE TREATMENT OF PIGMENT EPITHELIAL DETACHMENT IN NEOVASCULAR AGE-RELATED MACULAR DEGENERATION: Data from an Observational Study

Vaze, Anagha, MBBS, MPhil*; Nguyen, Vuong, PhD*; Daien, Vincent, MD, PhD*; Arnold, Jennifer, J., MBBS; Young, Stephanie, H., MBBS; Cheung, Chui, M., FRCOphth§,¶; Lamoureux, Ecosse, MSc, PhD§,¶; Bhargava, Mayuri, MBBS§; Barthelmes, Daniel, MD, PhD*,‖; Gillies, Mark, C., MBBS, PhD*the Fight Retinal Blindness Study Group

doi: 10.1097/IAE.0000000000001815
Original Study: PDF Only

Purpose: To assess the effect of intravitreal ranibizumab and aflibercept on retinal pigment epithelial detachment (RPED) in patients with neovascular age-related macular degeneration.

Methods: This was a retrospective analysis of data from a prospectively designed and implemented clinical audit. Analysis included change in RPED dimensions and visual acuity in 92/233 treatment-naive eyes with neovascular age-related macular degeneration and RPED 6 months after treatment with either aflibercept or ranibizumab.

Results: There was no significant between-group difference in the adjusted mean change for maximum RPED height (P = 0.195), diameter (P = 0.522) or visual acuity (P = 0.836) at 6 months. Injection frequency was the only clinical variable that affected RPED height (P = 0.050) and visual acuity change for both treatment groups (P = 0.004). Around 30% of eyes in each group had complete resolution of RPED at 6 months.

Conclusion: Eyes with neovascular age-related macular degeneration and RPED showed significant functional and anatomical responses after 6 months of intravitreal anti–vascular endothelial growth factor injections. However, we found no significant difference in anatomical response or change in visual acuity between eyes treated with ranibizumab compared with aflibercept. Larger, prospectively designed, randomized studies with longer term follow-up may identify a difference between the two drugs that we did not detect.

To date, there is limited information on the comparative efficacy of ranibizumab and aflibercept in terms of retinal pigment epithelial detachment resolution, retinal pigment epithelial tear rates, and visual acuity improvement in neovascular age-related macular degeneration eyes with retinal pigment epithelial detachment. The aim of this study was to study the effect of intravitreal ranibizumab and aflibercept on these retinal pigment epithelial detachment dimensions after 6 months of treatment in patients with neovascular age-related macular degeneration.

*The Save Sight Institute, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia;

Marsden Eye Specialists, Parramatta, New South Wales, Australia;

Gosford Eye Surgery, Gosford, New South Wales, Australia;

§Singapore Eye Research Institute, Singapore;

Duke-NUS Medical School, Singapore; and

Department of Ophthalmology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.

Reprint requests: Anagha Vaze, MBBS, MPhil, Save Sight Institute, Level 1, South Block, Sydney Eye Hospital, 8 Macquarie Street, Sydney, NSW 2000, Australia; e-mail: anagha.vaze@gmail.com

Supported by unrestricted educational grant from Novartis.

None of the authors has any conflicting interests to disclose.

© 2018 by Ophthalmic Communications Society, Inc.