The outcomes of aflibercept therapy in patients with age-related macular degeneration resistant to bevacizumab or ranibizumab

Purpose: this study was designed to assess the functional and anatomic outcomes of intravitreal aflibercept injection in patients with wet age-related macular degeneration (amd) refractory to intravitreal bevacizumab or ranibizumab therapy. methods: this retrospective study included 43 eyes of 43 patients resistant to treatment with at least 6 injections of bevacizumab or ranibizumab. persistent intraretinal and subretinal fluid (irf and srf) on optical coherence tomography (oct), no improvement in best corrected visual acuity (bcva), and a central macular thickness (cmt) increase of more than 100 μm due to srf and/or irf compared to baseline for at least 6 monthly intravitreal bevacizumab or ranibizumab injections were defined as resistant to bevacizumab/ranibizumab therapy. bcva, intraocular pressure (iop), cmt, maximum retinal thickness (mrt), and maximum pigment epithelial detachment (ped) height (mpedh) were evaluated before and after aflibercept injections. result: after initiating aflibercept treatment, the mean final bcva logarithm of the minimum angle of resolution or recognition (logmar) improved to 0.84 ± 0.59 which was statistically significant compared to baseline (1.14 ± 0.51), (p < 0.001). after aflibercept injection, statistically significant reduction was noted in mean cmt (402.6 ± 196.7 μm vs 264.2 ± 52.85 μm, p < 0.05), mrt (435.3 ± 195.2 μm vs 282.2 ± 31.8 μm, p < 0.05), and mpedh (154.2 ± 86.0 μm vs 68.3 ± 70.6 μm, p < 0.05). there was no correlation between the total number of previous injections and the increase of bcva (r = −0.10, p = 0.265). the decrease of mean iop was statistically significant under aflibercept treatment (p < 0.001). conclusions: the present study showed the efficacy of aflibercept treatment in eyes with persistent retinal or srf under bevacizumab or ranibizumab therapy. a significant anatomical and functional improvement was noted.